P-Transfemoral

Description:

L5321-Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee

The following add-on codes may be used for this base code (only code for what you use):

Frequently Related

L5650- total contact, above knee or knee disarticulation socket x1ea

L5653- Knee disarticulation, expandable wall socket x1ea

L5624- Test socket above knee x2ea (only if 2 check sockets are used)

L5950- Endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)

Socket

L5631- above knee or knee disarticulation, acrylic socket

L5642- Above knee leather socket

L5644- Above knee wood socket

L5648- Above knee cushion socket

L5649- ischial containment/narrow m-l socket

L5651- flexible inner socket, external frame

L5652- suction suspension, above knee or knee disarticulation socket

Socket Inserts

L5673- socket insert, silicone gel, elastomeric or equal, for use with locking mechanism

L5679- Socket insert w/o lock mech (custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism)

L5681- custom fabricated socket insert for 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 l5673 or l5679)

L5683- Initial custom socket insert (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 l5673 or l5679))

L5658- socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)

Suspension

L5692- Ak pelvic control belt light

L5694- pelvic control belt, padded and lined

L5695- pelvic control, sleeve suspension, neoprene or equal, each

L5696- above knee or knee disarticulation, pelvic joint

L5697- Ak/knee disartic pelvic band

L5698- above knee or knee disarticulation, silesian bandage

L5781- Lower limb pros vacuum pump

L5782- vacuum pump, residual limb volume management and moisture evacuation system, heavy duty

L5985- Lwr ext dynamic prosth pylon

L5699- Shoulder harness

Endo Knees

L5610-K3- Above knee hydracadence

L5611-K1- 4 bar linkage, with friction swing phase control

L5613-K3- 4 bar linkage, with hydraulic swing phase control

L5616-K1- above knee, universal multiplex system, friction swing phase control

L5810-K1- single axis, manual lock

L5811-K1- single axis, manual lock, ultra-light material

L5812-K1- single axis, friction swing and stance phase control (safety knee)

L5814-K3- polycentric, hydraulic swing phase control, mechanical stance phase lock

L5816-K1- polycentric, mechanical stance phase lock

L5818-K1- polycentric, friction swing, and stance phase control

L5822-K3- single axis, pneumatic swing, friction stance phase control

L5824-K3- single axis, fluid swing phase control

L5826-K3- single axis, hydraulic swing phase control, with miniature high activity frame

L5828-K3- single axis, fluid swing and stance phase control

L5830-K3- single axis, pneumatic/ swing phase control

L5840-K3- 4-bar linkage or multiaxial, pneumatic swing phase control

L5845-K1- stance flexion feature, adjustable

L5848-K3- fluid stance extension, dampening feature, with or without adjustability

L5850-K1- above knee or hip disarticulation, knee extension assist

L5856-K3- microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type

L5857-K3- microprocessor control feature, swing phase only, includes electronic sensor(s), any type

L5858-K3- microprocessor control feature, stance phase only, includes electronic sensor(s), any type

L5859- powered and programmable flexion/extension assist control, includes any type motor(s)

L5925-K1- above knee, knee disarticulation or hip disarticulation, manual lock

L5930-K4- high activity knee control frame

Feet/Ankles

L5968- Multiaxial ankle w dorsiflex

L5969- endoskeletal ankle-foot or ankle system, power assist, includes any type motor(s)

L5970-K1- Foot external keel sach foot

L5972-K2- Flexible keel foot

L5973-K3- Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source

L5974-K1- Foot single axis ankle/foot

L5975-K2- combination single axis ankle and flexible keel foot

L5976-K3- energy storing foot (seattle carbon copy ii or equal)

L5978-K2- Ft prosth multiaxial ankl/ft

L5979-K3- multi-axial ankle, dynamic response foot, one piece system

L5980-K3- Flex foot system

L5981-K3- Flex-walk sys low ext prosth

L5984-K2- axial rotation unit, with or without adjustability

L5986-K2- Multi-axial rotation unit

L5987-K3- shank foot system with vertical loading pylon

L5990- User adjustable heel height

Socks-generally limited to 12 total socks, 2 shrinker

L8410- Prosthetic sheath, above knee, each

L8417- Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each

L8430- Prosthetic sock, multiple ply, above knee, each

L8460- Shrinker above knee

L8480- Pros sock single ply ak

Miscellaneous

L5617- quick change self-aligning unit, above knee or below knee, each

L5985- Lwr ext dynamic prosth pylon

L5988- Vertical shock reducing pylo

L7600- Prosthetic donning sleeve, any material, each

Repairs

L7510- Repair of prosthetic device, repair or replace minor parts

L7520- Repair prosthetic device, labor component, per 15 minutes

L5971- All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only

Orthotic or Prosthetic Lcodes: Px-Lower Extremity
ICD10 Code:: S88.0-Complete traumatic amp at knee level, Z89.6-Acquired absence of left leg above knee
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Disclaimer: Responsibility for accurate coding lies solely with the clinician treating the patient. OandP Academy assumes no responsibility or liability for the provider’s coding decisions. OandP Academy coding suggestions rest on its best judgment and are subject to revision based on additional information or changes in the alpha-numeric system. Ultimately it is your responsibility to code appropriately. Code using this tool at your own risk. OandP Academy suggest that there is documentation of what is being provided to the patient and that services furnished are clinically justified.
Description:

L5560-Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model

We do not suggest billing add-on codes with the base code above. 

Orthotic or Prosthetic Lcodes: Px-Lower Extremity
ICD10 Code:: Z89.619-Acquired absence of unspecified leg above knee, Z89.612-Acquired absence of LEFT leg above knee, Z89.611-Acquired absence of RIGHT leg above knee,
Disclaimer: Responsibility for accurate coding lies solely with the clinician treating the patient. OandP Academy assumes no responsibility or liability for the provider’s coding decisions. OandP Academy coding suggestions rest on its best judgment and are subject to revision based on additional information or changes in the alpha-numeric system. Ultimately it is your responsibility to code appropriately. Code using this tool at your own risk. OandP Academy suggest that there is documentation of what is being provided to the patient and that services furnished are clinically justified.
Description:

L5580-Preparatory, above knee – knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model

The following add-on codes may be used for this base code (only code for what you use):

Frequently Related

L5920- above knee or hip disarticulation, alignable system

L5650- Total contact, above knee or knee disarticulation socket x1ea

L5653- Knee disarticulation, expandable wall socket x1ea

L5622- Test socket, knee disarticulation x2ea (only if 2 check sockets are used)

 Socket

L5631- Above knee or knee disarticulation, acrylic socket

L5648- Above knee cushion socket

L5649- Ischial containment/narrow m-l socket

L5651- Flexible inner socket, external frame

L5652- Suction suspension, above knee or knee disarticulation socket

L5653- Knee disarticulation, expandable wall socket

Socket Inserts

L5656- Socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)

L5673- Socket insert, silicone gel, elastomeric or equal, for use with locking mechanism

L5679- Socket insert w/o lock mech (custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism)

L5681- Custom fabricated socket insert for 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 l5673 or l5679)

L5683- Initial custom socket insert (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 l5673 or l5679))

Suspension

L5671- Below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert

L5684- Bk fork strap

L5686- Below knee, back check (extension control)

L5688- Bk waist belt webbing

L5690- Below knee, waist belt, padded and lined

L5692- Ak pelvic control belt light

L5694- Pelvic control belt, padded and lined

L5695- Pelvic control, sleeve suspension, neoprene or equal, each

L5696- Above knee or knee disarticulation, pelvic joint

L5697- Ak/knee disartic pelvic band

L5698- Above knee or knee disarticulation, silesian bandage

L5699- Shoulder harness

Endo Knees

L5611-K1- 4 bar linkage, with friction swing phase control

L5613-K3- 4 bar linkage, with hydraulic swing phase control

L5616-K1- Above knee, universal multiplex system, friction swing phase control

L5810-K1- Single axis, manual lock

L5811-K1- Single axis, manual lock, ultra-light material

L5812-K1- Single axis, friction swing and stance phase control (safety knee)

L5814-K3- Polycentric, hydraulic swing phase control, mechanical stance phase lock

L5816-K1- Polycentric, mechanical stance phase lock

L5818-K1- Polycentric, friction swing, and stance phase control

L5822-K3- Single axis, pneumatic swing, friction stance phase control

L5824-K3- Single axis, fluid swing phase control

L5826-K3- Single axis, hydraulic swing phase control, with miniature high activity frame

L5828-K3- Single axis, fluid swing and stance phase control

L5830-K3- Single axis, pneumatic/ swing phase control

L5840-K3- 4-bar linkage or multiaxial, pneumatic swing phase control

L5845-K1- Stance flexion feature, adjustable

L5848-K3- Fluid stance extension, dampening feature, with or without adjustability

L5856-K3- Microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type

L5857-K3- Microprocessor control feature, swing phase only, includes electronic sensor(s), any type

L5859- Powered and programmable flexion/extension assist control, includes any type motor(s)

L5925-K1- Above knee, knee disarticulation or hip disarticulation, manual lock

L5930-K4- High activity knee control frame

Knee Joints

L5676- Below knee, joint covers, pair

L5677- Below knee, knee joints, polycentric, pair

L5678- Below knee, joint covers, pair

Feet/Ankles

L5968- Multiaxial ankle w dorsiflex

L5969- endoskeletal ankle-foot or ankle system, power assist, includes any type motor(s)

L5970-K1- Foot external keel sach foot

L5971- Solid ankle cushion heel (sach) foot, replacement only

L5972-K2- Flexible keel foot

L5973-K3- Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source

L5974-K1- Foot single axis ankle/foot

L5975-K2- Combination single axis ankle and flexible keel foot

L5976-K3- Energy storing foot (seattle carbon copy ii or equal)

L5978-K2- Ft prosth multiaxial ankl/ft

L5979-K3- Multi-axial ankle, dynamic response foot, one piece system

L5980-K3- Flex foot system

L5981-K3- Flex-walk sys low ext prosth

L5986-K2- Multi-axial rotation unit

L5987-K3- shank foot system with vertical loading pylon

L5990- User adjustable heel height

L5984-K2- Axial rotation unit, with or without adjustability

Socks-generally limited to 12 total socks, 2 shrinker

L8410- Prosthetic sheath, above knee, each

L8417- Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each

L8430- Prosthetic sock, multiple ply, above knee, each

L8460- Shrinker above knee

L8480- Pros sock single ply ak

Miscellaneous

L5617- quick change self-aligning unit, above knee or below knee, each

L5781- Vacuum pump, residual limb volume management and moisture evacuation system

L5782- Vacuum pump, residual limb volume management and moisture evacuation system, heavy duty

L5985- Lwr ext dynamic prosth pylon

L5988- Vertical shock reducing pylo

L5706- Custom shaped protective cover, knee disarticulation

L5964- Above knee, flexible protective outer surface covering system

L7600- Prosthetic donning sleeve, any material, each

L5999- Lower extremity prosthesis, not otherwise specified

L8499-Unlisted procedure for miscellaneous prosthetic services

Repairs

L7510- Repair of prosthetic device, repair or replace minor parts

L7520- Repair prosthetic device, labor component, per 15 minutes

Orthotic or Prosthetic Lcodes: Px-Lower Extremity
ICD10 Code:: Z89.619-Acquired absence of unspecified leg above knee, Z89.612-Acquired absence of LEFT leg above knee, Z89.611-Acquired absence of RIGHT leg above knee,
Disclaimer: Responsibility for accurate coding lies solely with the clinician treating the patient. OandP Academy assumes no responsibility or liability for the provider’s coding decisions. OandP Academy coding suggestions rest on its best judgment and are subject to revision based on additional information or changes in the alpha-numeric system. Ultimately it is your responsibility to code appropriately. Code using this tool at your own risk. OandP Academy suggest that there is documentation of what is being provided to the patient and that services furnished are clinically justified.
Description:

L5580-Preparatory, above knee – knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model

The following add-on codes may be used for this base code (only code for what you use):

Frequently Related

L5650- total contact, above knee or knee disarticulation socket x1ea

L5653- Knee disarticulation, expandable wall socket x1ea

L5624- Test socket above knee x2ea (only if 2 check sockets are used)

L5950- Endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)

Socket

L5649- ischial containment/narrow m-l socket

L5651- flexible inner socket, external frame

L5652- suction suspension, above knee or knee disarticulation socket

Socket Inserts

L5673- socket insert, silicone gel, elastomeric or equal, for use with locking mechanism

L5679- Socket insert w/o lock mech (custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism)

L5681- custom fabricated socket insert for 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 l5673 or l5679)

L5683- Initial custom socket insert (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 l5673 or l5679))

L5658- socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)

Suspension

L5692- Ak pelvic control belt light

L5694- pelvic control belt, padded and lined

L5695- pelvic control, sleeve suspension, neoprene or equal, each

L5696- above knee or knee disarticulation, pelvic joint

L5697- Ak/knee disartic pelvic band

L5698- above knee or knee disarticulation, silesian bandage

L5781- Lower limb pros vacuum pump

L5782- vacuum pump, residual limb volume management and moisture evacuation system, heavy duty

L5985- Lwr ext dynamic prosth pylon

L5699- Shoulder harness

Endo Knees

L5610-K3- Above knee hydracadence

L5611-K1- 4 bar linkage, with friction swing phase control

L5613-K3- 4 bar linkage, with hydraulic swing phase control

L5616-K1- above knee, universal multiplex system, friction swing phase control

L5810-K1- single axis, manual lock

L5811-K1- single axis, manual lock, ultra-light material

L5812-K1- single axis, friction swing and stance phase control (safety knee)

L5814-K3- polycentric, hydraulic swing phase control, mechanical stance phase lock

L5816-K1- polycentric, mechanical stance phase lock

L5818-K1- polycentric, friction swing, and stance phase control

L5822-K3- single axis, pneumatic swing, friction stance phase control

L5824-K3- single axis, fluid swing phase control

L5826-K3- single axis, hydraulic swing phase control, with miniature high activity frame

L5828-K3- single axis, fluid swing and stance phase control

L5830-K3- single axis, pneumatic/ swing phase control

L5840-K3- 4-bar linkage or multiaxial, pneumatic swing phase control

L5845-K1- stance flexion feature, adjustable

L5848-K3- fluid stance extension, dampening feature, with or without adjustability

L5850-K1- above knee or hip disarticulation, knee extension assist

L5856-K3- microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type

L5857-K3- microprocessor control feature, swing phase only, includes electronic sensor(s), any type

L5858-K3- microprocessor control feature, stance phase only, includes electronic sensor(s), any type

L5859- powered and programmable flexion/extension assist control, includes any type motor(s)

L5925-K1- above knee, knee disarticulation or hip disarticulation, manual lock

L5930-K4- high activity knee control frame

Feet/Ankles

L5968- Multiaxial ankle w dorsiflex

L5969- endoskeletal ankle-foot or ankle system, power assist, includes any type motor(s)

L5970-K1- Foot external keel sach foot

L5972-K2- Flexible keel foot

L5973-K3- Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source

L5974-K1- Foot single axis ankle/foot

L5975-K2- combination single axis ankle and flexible keel foot

L5976-K3- energy storing foot (seattle carbon copy ii or equal)

L5978-K2- Ft prosth multiaxial ankl/ft

L5979-K3- multi-axial ankle, dynamic response foot, one piece system

L5980-K3- Flex foot system

L5981-K3- Flex-walk sys low ext prosth

L5984-K2- axial rotation unit, with or without adjustability

L5986-K2- Multi-axial rotation unit

L5987-K3- shank foot system with vertical loading pylon

L5990- User adjustable heel height

Socks-generally limited to 12 total socks, 2 shrinker

L8410- Prosthetic sheath, above knee, each

L8417- Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each

L8430- Prosthetic sock, multiple ply, above knee, each

L8460- Shrinker above knee

L8480- Pros sock single ply ak

Miscellaneous

L5617- quick change self-aligning unit, above knee or below knee, each

L5985- Lwr ext dynamic prosth pylon

L5988- Vertical shock reducing pylo

L7600- Prosthetic donning sleeve, any material, each

Repairs

L7510- Repair of prosthetic device, repair or replace minor parts

L7520- Repair prosthetic device, labor component, per 15 minutes

L5971- All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only

Orthotic or Prosthetic Lcodes: Px-Lower Extremity
ICD10 Code:: S88.0-Complete traumatic amp at knee level, Z89.6-Acquired absence of left leg above knee
Disclaimer: Responsibility for accurate coding lies solely with the clinician treating the patient. OandP Academy assumes no responsibility or liability for the provider’s coding decisions. OandP Academy coding suggestions rest on its best judgment and are subject to revision based on additional information or changes in the alpha-numeric system. Ultimately it is your responsibility to code appropriately. Code using this tool at your own risk. OandP Academy suggest that there is documentation of what is being provided to the patient and that services furnished are clinically justified.
Description:

L5585-Preparatory, above knee – knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket
The following add-on codes may be used for this base code (only code for what you use):
Frequently Related
L5684- Bk fork strap

L5688- Bk waist belt webbing

L5999- Lower extremity prosthesis, not otherwise specified

Orthotic or Prosthetic Lcodes: Px-Lower Extremity
ICD10 Code:: Z89.619-Acquired absence of unspecified leg above knee, Z89.612-Acquired absence of LEFT leg above knee, Z89.611-Acquired absence of RIGHT leg above knee,
Disclaimer: Responsibility for accurate coding lies solely with the clinician treating the patient. OandP Academy assumes no responsibility or liability for the provider’s coding decisions. OandP Academy coding suggestions rest on its best judgment and are subject to revision based on additional information or changes in the alpha-numeric system. Ultimately it is your responsibility to code appropriately. Code using this tool at your own risk. OandP Academy suggest that there is documentation of what is being provided to the patient and that services furnished are clinically justified.