L8609, Artificial cornea
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- No specific documentation requirements are provided in this excerpt.
- No explicit documentation requirements are provided in this excerpt.
- The document references a 'Coverage Limitations' section for further details (not included) which may contain documentation requirements.
- Documentation of surface-detectable electromyographic (EMG) signals from the residual limb when proposing a myoelectric prosthesis (inferred from: "Electromyographic signals from the limb stump are detected by surface electrodes ... to drive ... motors").
Key Coverage Criteria
- No explicit covered indications/diagnoses/clinical scenarios are provided in the supplied document excerpt.
- Replacement of a missing body part (prosthesis), including arms, breasts, ears, feet, hands, legs and maxillofacial (jaw and face).
- Lower limb prostheses designed to replace portions of the lower extremity to improve function.
- Use of a prosthetic knee to provide support during the stance phase of ambulation.
- Use of a prosthetic knee to produce smooth control during the swing phase of ambulation.
- L6680 | Upper extremity addition, test socket, wrist disarticulation or below elbow
8 Active Policies
HUMANA-PROSTHETICS-KY-MEDICAID, Prosthetics
ANTHEM-CG-SURG-94, CG-SURG-94 Keratoprosthesis
AMBETTER-CP.MP.107, Durable Medical Equipment and Orthotics and Prosthetics Guidelines
OTH903.030, Keratoprosthesis
BCBSIL-OTH903.030, Keratoprosthesis
Related Codes
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