HCPCS code L5694 — Ak pelvic control belt pad/l. Status: Active. Effective Jan 1, 1986. Source: CMS HCPCS Level II.

L5694

Active

Ak pelvic control belt pad/l

Addition to lower extremity, above knee, pelvic control belt, padded and lined

Category: Orthotics & Prosthetics
Section: L-codes: Orthotic and Prosthetic Procedures
Effective: Jan 1, 1986
Code type: alphanumeric
OPPS Status: A — Paid under a separate fee schedule (not OPPS)

MUE — Medically Unlikely Edits

Maximum units of L5694 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.

Service Type Max Units / Day
DME Supplier 2
Outpatient Hospital 2
Practitioner Services 0

Source: CMS Medicare NCCI Medically Unlikely Edits