HCPCS code
Prosthetics
CMS description
All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only
In the order to send them
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