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L7404
Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material
HCPCS code
Medical Policies and Guidelines for Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material
Related policies from health plans
HUMANA
Prosthetics
HUMANA
Prosthetics
Similar Codes
ICD10CM codes
T84.028A
- Dislocation of other internal joint prosthesis, initial encounter
Z44.022
- Encounter for fitting and adjustment of partial artificial left arm
Z44.012
- Encounter for fitting and adjustment of complete left artificial arm
Z44.002
- Encounter for fitting and adjustment of unspecified left artificial arm
T84.029A
- Dislocation of unspecified internal joint prosthesis, initial encounter
Z44.00
- Encounter for fitting and adjustment of unspecified artificial arm
Z44.021
- Encounter for fitting and adjustment of partial artificial right arm
T84.028
- Dislocation of other internal joint prosthesis
Z44.02
- Encounter for fitting and adjustment of partial artificial arm
Z44.011
- Encounter for fitting and adjustment of complete right artificial arm
HCPCS codes
L7404
- Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material
L7403
- Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material
L7401
- Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium,
L7400
- Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (tita
L5631
- Addition to lower extremity, above knee or knee disarticulation, acrylic socket
L6688
- Upper extremity addition, frame type socket, above elbow or elbow disarticulation
L6694
- Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mol
L6687
- Upper extremity addition, frame type socket, below elbow or wrist disarticulation
L6696
- Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for
L6682
- Upper extremity addition, test socket, elbow disarticulation or above elbow
CPT4 codes
25442
- Arthroplasty with prosthetic replacement; distal ulna
25444
- Arthroplasty with prosthetic replacement; lunate
24371
- Revision of total elbow arthroplasty, including allograft when performed; humeral and ulnar componen
24363
- Arthroplasty, elbow; with distal humerus and proximal ulnar prosthetic replacement (eg, total elbow)
24362
- Arthroplasty, elbow; with implant and fascia lata ligament reconstruction
25441
- Arthroplasty with prosthetic replacement; distal radius
24587
- Open treatment of periarticular fracture and/or dislocation of the elbow (fracture distal humerus an
21270
- Malar augmentation, prosthetic material
73201
- Computed tomography, upper extremity; with contrast material(s)
21125
- Augmentation, mandibular body or angle; prosthetic material