L5703 – Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only

Long description

Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only

Short description

Symes ankle w/o (sach) foot

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, 2006

Last change

January 1, 2006 – No change

Nearby L codes

• L5695 – Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each
• L5696 – Addition to lower extremity, above knee or knee disarticulation, pelvic joint
• L5697 – Addition to lower extremity, above knee or knee disarticulation, pelvic band
• L5698 – Addition to lower extremity, above knee or knee disarticulation, silesian bandage
• L5699 – All lower extremity prostheses, shoulder harness
• L5700 – Replacement, socket, below knee, molded to patient model
• L5701 – Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model
• L5702 – Replacement, socket, hip disarticulation, including hip joint, molded to patient model
• L5704 – Custom shaped protective cover, below knee
• L5705 – Custom shaped protective cover, above knee
• L5706 – Custom shaped protective cover, knee disarticulation
• L5707 – Custom shaped protective cover, hip disarticulation
• L5710 – Addition, exoskeletal knee-shin system, single axis, manual lock
• L5711 – Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material
• L5712 – Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)
• L5714 – Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control