Preparatory, above knee – knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed
Short Description: Prep ak ischial direct form
Coverage Code: Carrier judgment
Action Code: No maintenance for this code
Date Added: January 1, 1986
Effective Date: January 1, 1996
Termination Date: