HCPCS Code Details - L5704

HCPCS Level II Code
Orthotic and Prosthetic Procedures, Devices
HCPCS Code L5704
Description

Long description:
Custom shaped protective cover, below knee

Short description:
Custom shape cover bk

HCPCS Modifier1
HCPCS Pricing indicator 38 - Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings)
Multiple pricing indicator A - Not applicable as HCPCS priced under one methodology
Coverage code C - Carrier judgment
BETOS2 code D1F - Prosthetic/Orthotic devices
HCPCS Action code N - No maintenance for this code
Type of service P - Lump sum purchase of DME, prosthetics, orthotics
Effective date Effective Jan 01, 2002
Date added Added Jan 01, 1994
HCPCS Coding Procedures

HCPCS Modifiers

In HCPCS Level II, modifiers are composed of two alpha or alphanumeric characters.

Example: E0260-NU - Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress
NU” identifies the hospital bed as new equipment

See also

  • HCPCS L5703 · Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only

  • HCPCS L5705 · Custom shaped protective cover, above knee

  • HCPCS L5706 · Custom shaped protective cover, knee disarticulation

  • HCPCS L5707 · Custom shaped protective cover, hip disarticulation


1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).

2 BETOS stands for “Berenson-Eggers Type Of Service”