Limits Updated for Select Orthotic and Prosthetic Procedure Codes

Effective Aug. 28, 2018, claim edits for upper and lower extremity prosthetic test sockets (procedure codes L5618-L5628, L6680-L6684) were updated to allow payment for two test sockets during a six-month period when medically necessary. Claim edits for above-knee sleeve suspension (L5695) were also updated to allow payment for two sleeves during a six-month period when medically necessary.

Additionally, claim edits for addition to lower extremity orthotic (L2755) were updated to allow payment for up to four segments per orthotic when medically necessary.