HCPCS code
Prosthetics
CMS description
Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device
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