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L8020 - Mastectomy form

Navigation: HCPCS Codes > Codes with Prefix: L8
Field Value
HCPCS Code: L8020
Long Description: Breast prosthesis, mastectomy form
Short Description: Mastectomy form
Pricing Indicator 1: 38 (Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings))
Multiple Pricing Code: A (Not applicable as HCPCS priced under one methodology)
MCM Reference Section Number 1: 2130 A
Statute Number:
Coverage Code: D (Special coverage instructions apply)
ASC Payment Group Code:
Processing Note Number:
Berenson-Eggers Type of Service (BETOS) Code: D1F (Orthotic devices)
Type of Service Code 1: P (Lump sum purchase of DME, prosthetics, orthotics)
Anesthesia Base Unit Quality: 0
Code Added: 01-01-1986
Action Effective Date: 01-01-1996
Action Code: N (No maintenance for this code)