Billing Reminder - Lower Limb Suction Valve Prosthesis

Posted September 09, 2011

Use of HCPCS Code L5647, L5652 and L5671 - Reminder

L5671 describes both the part of the suspension locking mechanism that is integrated into the prosthesis socket and the pin(s), lanyard, or other component which is attached to the socket insert. L5671 does not include the socket insert itself.

Code L5647 describes a type of suspension system and is intended for use with sockets that incorporate a suction valve in their design.

The parallel code for above knee prostheses is code L5652 (addition to lower extremity, suction suspension, above knee or knee disarticulation socket).

Codes L5647 and L5652 describe a modification to a prosthetic socket that incorporates a suction valve in the design. The items described by these codes are not components of a suspension locking mechanism (L5671); therefore Medicare does not allow separate billing or payment for code L5671.

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