Field Name |
Field Value |
Healthcare Common Procedure Coding System Code |
L6697 |
HCPCS Sequence Number |
0010 |
HCPCS Record Identification Code |
3 - First line of procedure record also contains detail information in positions 92-275 |
HCPCS Long Description |
Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695) |
HCPCS Short Description |
Cus elbo skt in not con/atyp |
HCPCS Pricing Indicator Code 1 |
38 - Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings) |
HCPCS Multiple Pricing Indicator Code |
A - Not applicable as HCPCS priced under one methodology |
HCPCS Coverage Code |
C - Carrier judgment |
HCPCS Berenson-Eggers Type Of Service Code |
D1F - Prosthetic/Orthotic devices |
HCPCS Type Of Service Code 1 |
P - Lump sum purchase of DME, prosthetics, orthotics |
HCPCS Anesthesia Base Unit Quantity |
0 |
HCPCS Code Added Date |
1/1/2005 |
HCPCS Action Effective Date |
1/1/2005 |
HCPCS Action Code |
N - No maintenance for this code |