|
L7499 |
 |
Upper extremity prosthesis, not otherwise specified
| short | Upper extremity prosthes nos |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
L7510 |
 |
Repair of prosthetic device, repair or replace minor parts
| short | Prosthetic device repair rep |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 4.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | OPH | 4.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | DME | 4.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
|
|
|
|
L7520 |
 |
Repair prosthetic device, labor component, per 15 minutes
| short | Repair prosthesis per 15 min |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 12.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
|
|
|
|
L7600 |
 |
Prosthetic donning sleeve, any material, each
| short | Prosthetic donning sleeve |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|