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HCPCS Level II Table of Contents

L6300 - L6320  Prosthetic Procedures - Shoulder Disarticulation

L6300
Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm
shortShlder disart int lock elbow
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.02 Date of Service Edit: PolicyAnatomic Consideration
DME2.02 Date of Service Edit: PolicyAnatomic Consideration
L6310
Shoulder disarticulation, passive restoration (complete prosthesis)
shortShoulder passive restor comp
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.02 Date of Service Edit: PolicyAnatomic Consideration
DME2.02 Date of Service Edit: PolicyAnatomic Consideration
L6320
Shoulder disarticulation, passive restoration (shoulder cap only)
shortShoulder passive restor cap
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.02 Date of Service Edit: PolicyAnatomic Consideration
DME2.02 Date of Service Edit: PolicyAnatomic Consideration