HCPCS Code Section: HCPCS L Codes

Interscapular thoracic, passive restoration (complete prosthesis) Short Description: Thoracic passive restor comp Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 1986 Effective …

Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm Short Description: Thoracic intern lock elbow Coverage Code: Carrier judgment Action Code: No maintenance for this code …

Shoulder disarticulation, passive restoration (shoulder cap only) Short Description: Shoulder passive restor cap Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 1982 …

Shoulder disarticulation, passive restoration (complete prosthesis) Short Description: Shoulder passive restor comp Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 1982 Effective …

Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no …

Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping Short Description: Scap thorac prosth tiss shap Coverage Code: Carrier judgment Action Code: No maintenance for this code …

Upper extremity addition, spring assisted rotational wrist unit with latch release Short Description: Spring-ass rot wrst w/ latch Coverage Code: Carrier judgment Action Code: No maintenance for this code …

Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping Short Description: Shldr disar prosth tiss shap Coverage Code: Carrier judgment Action Code: No maintenance for this code …

Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device Short Description: Flex/ext wrist w/wo friction Coverage Code: Carrier judgment Action Code: …

Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping Short Description: Above elbow prosth tiss shap Coverage Code: Carrier judgment Action Code: No maintenance for this code …