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L6130 Service Type Codes to Send

HCPCS code

Prosthetics

CMS description

Below elbow, molded double wall split socket, stump activated locking hinge, half cuff

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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