L5668 – Addition to lower extremity, below knee, molded distal cushion

Long description

Addition to lower extremity, below knee, molded distal cushion

Short description

Bk molded distal cushion

Pricing indicator

38 Orthotics, prosthetics, prosthetic devices & vision services

Medicare coverage

C Carrier judgment – coverage decided by the Medicare contractor

BETOS category

D1F Prosthetic/Orthotic devices

Added

January 1, 1986

Last change

January 1, 2014 – No change

Nearby L codes

• L5654 – Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)
• L5655 – Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)
• L5656 – Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)
• L5657 – Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials
• L5658 – Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)
• L5661 – Addition to lower extremity, socket insert, multi-durometer symes
• L5665 – Addition to lower extremity, socket insert, multi-durometer, below knee
• L5666 – Addition to lower extremity, below knee, cuff suspension
• L5670 – Addition to lower extremity, below knee, molded supracondylar suspension ('pts' or similar)
• L5671 – Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert
• L5672 – Addition to lower extremity, below knee, removable medial brim suspension
• L5673 – Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism
• L5676 – Additions to lower extremity, below knee, knee joints, single axis, pair
• L5677 – Additions to lower extremity, below knee, knee joints, polycentric, pair
• L5678 – Additions to lower extremity, below knee, joint covers, pair
• L5679 – Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism