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L5699 Service Type Codes to Send

HCPCS code

Prosthetics

CMS description

All lower extremity prostheses, shoulder harness

Why these codes

Prosthetic devices have their own STC; DME is the fallback.

If a payer returns nothing

Payers don't all answer every service type. Send 30 (Health Benefit Plan Coverage) for the plan's general benefits.

Sources

CMS HCPCS Level II descriptor; X12 HIPAA 5010 service type code definitions; VerifyTX billing practice

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