Lower Limb Prostheses Policy Updates Effective September 1, 2024

The Lower Limb Prostheses (LLP) Local Coverage Determination (LCD) and Policy Article (PA) have been updated to reflect the following changes:

Effective September 1, 2024, all LLP HCPCS codes must be submitted with the KX, GA, GZ, or GY modifier. The LT or RT modifiers are still a requirement. If a claim is submitted for an LLP HCPCS code and is missing these modifier requirements, the claim will be rejected and will need to be corrected and resubmitted.

In addition, effective September 1, 2024, HCPCS codes L5615 and L5841 will now require either a K0, K1, K2, K3, or K4 modifier.

Lastly, HCPCS codes L5973, L5976, L5979, L5980, L5981, L5987, L5610, L5613, L5614, L5615, L5722, L5724, L5726, L5728, L5780, L5814, L5822, L5824, L5826, L5828, L5830, L5840, L5841, L5848, L5856, L5857, and L5858 can now be allowed with the K2, K3, or K4 modifier. Previously, these HCPCS codes were only allowed with a K3 or K4 modifier.

For more information, refer to the Lower Limb Prostheses LCD L33787

Last Updated Aug 13 , 2024