2024 HCPCS Code L8701

Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated

Short Description	Ewh s/d uprt micro sensor
HCPCS Coverage Code	C - Carrier judgment
HCPCS Action Code	N - No maintenance for this code
HCPCS Action Effective Date	January 01, 2024
HCPCS Code Added Date	January 01, 2019
HCPCS Pricing Indicator Code	38 - Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings)
HCPCS Multiple Pricing Indicator Code	A - Not applicable as HCPCS priced under one methodology
HCPCS Coverage Issues Manual Reference Section Number
HCPCS Type Of Service Code	P - Lump sum purchase of DME, prosthetics, orthotics
HCPCS Anesthesia Base Unit Quantity	0