Upper Extremity Prosthetic Myoelectronic Control - Correct Coding and Code Verification Review Requirement - JA DME

Joint DME MAC and PDAC Publication
Posted June 5, 2025

HCPCS code L6700 (UPPER EXTREMITY ADDITION, EXTERNAL POWERED FEATURE, MYOELECTRONIC CONTROL MODULE, ADDITIONAL EMG INPUTS, PATTERN-RECOGNITION DECODING INTENT MOVEMENT) describes an addition to a myoelectric controlled upper extremity prosthesis. The code describes a distinct and separate physical component with the following requirements:

1. The product must have the capacity to gather, decode, and integrate simultaneous myographic signals from a minimum array of 3 electromyographic (EMG) sites.
2. The product’s machine learning algorithms recognize and simultaneously decode complex EMG patterns in determining an individual’s real-time movement intent. The product translates command signals into commands to direct functional motion of electric powered components.
3. The product provides intuitive control of myoelectric prosthetic components, such as terminal devices, wrist units, elbows, etc.
4. The predicate products for L6700 are Coapt’s Complete Control Gen2, Ottobock’s MyoPlus, and Infinite Biomedical Technologies’ Sense.

The unit of service (UOS) is one per limb. Use of L7499 to describe features and functions included in the product is incorrect coding, unbundling.

The only products which may be billed using L6700 HCPCS code are those products assigned L6700 and listed on the Product Classification List (PCL) of the Pricing, Data Analysis and Coding (PDAC) contractor website. The DME MACs are issuing a Coding Verification Requirement for L6700 effective for claims with dates of service on or after July 1, 2025.

The CMS Internet Only Manual (IOM), Publication 100-08, PIM, Chapter 3, Sections 3.3.B and 3.6.2.4 indicate that for Medicare claims, the Centers for Medicare and Medicaid Services (CMS) and the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) have the authority to establish HCPCS Level II Coding Guidelines. Pursuant to 42 CFR § 414.40 and 45 CFR § 162.1002, CMS has the authority to assign and manage HCPCS codes (create, delete, change code narrative etc.).

Correct coding is an essential element for correct claim payment. The PDAC contractor maintains a variety of resources to assist suppliers in determining the appropriate code for Medicare billing. For questions about correct coding, contact the PDAC HCPCS Helpline at (877) 735-1326 during the hours of 9:30 a.m. to 5:00 p.m. ET, Monday through Friday. You may also visit the PDAC website to chat with a representative or select the Contact Us button at the top of the PDAC website for email, FAX, or postal mail information.

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