Table of content for "4-bar link above knee w/swng" (HCPCS L5614)
General information on the “L5614” code
HCPCS Code: L5614
Long Description: Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control
Short Description: 4-bar link above knee w/swng
Original information is taken from L5614 page
Pricing indicators
Pricing Indicator Code 1: 38 – Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings) . Durable Medical Equipment, Prosthetics, Orthotics, Supplies And Surgical Dressings
Multiple Pricing Indicator Code A : Not applicable as HCPCS priced under one methodology
Certification and additional reference information
Coverage
Coverage: C – Carrier judgment
Type of service
Berenson-Eggers Type of Service (BETOS): D1F – Prosthetic/Orthotic devices
Type Of Service 1: P – Lump sum purchase of DME, prosthetics, orthotics
Misc information
Anesthesia Base Unit Quantity: 0
Code Added Date: 19940101
Code Effective Date: 19960101
Action Code: N – No maintenance for this code