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L5657 - HCPCS Level II | Verity

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HCPCS Level IIprostheticsActive

L5657

Add low ext man aut vol any

BETOS: D1F

Effective: 2025-10-01

Referenced in 2 policies

Description

Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials

Coverage Policies

This code is referenced in 2 Medicare coverage policies

Sample Policies

ANTHEM-CG-DME-13PayerPolicy

covered

CG-DME-13 Lower Limb Prosthesis

L33787LCDcovered

Lower Limb Prostheses

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About HCPCS Level II

Healthcare Common Procedure Coding System Level II codes for supplies, equipment, and non-physician services

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