Code Verification Review Requirement for Articulating Digit(s) and Prosthetic Hands
                     Code Verification Review Requirement for 
Articulating Digit(s) and Prosthetic Hands
On November 11, 2021, the DME MACs published an announcement on 
the coding guidance regarding the terminal devices upper extremity. The 
new announcement edited the previous guidance on the use of L6881 
that was provided in November 2019. It was the auto grasp feature.
The addition done to the L6881 automatic grasp feature made an 
addition to the electronic upper limb prosthetic terminal device. It 
unbundled the revision, including L6882 and the controlling 
microprocessor feature. 
What does This Mean? 
The joint DME MAC publication and PDAC Article mean the claims will 
be effective for services dated on and after January 1, 2022. 
Read more..
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Code Verification Review Requirement for 
Articulating Digit(s) and Prosthetic Hands
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Code Verification Review Requirement for 
Articulating Digit(s) and Prosthetic Hands
•              L6715 – terminal device 
- Multiple articulation digits 
- Includes motor(s) 
-           Initial issue or replacement 
• L6880 – electric hand, 
- switch or myoelectric controlled, 
- Independently articulating digits 
- Any grasp pattern 
- Combination of grasp patterns
These two and the variations under it have received the reviewed code 
verification, which is mandatory while undertaking medical billing and 
coding. The further details are listed in the PDAC (Pricing, Data 
Analysis, and Coding) of the PCL (Product Classification List) contractor 
website. 
It was also mandatory for the manufacturers who have these products 
and are under these categories to submit the products to verify the 
coding by August 31, 2021. 
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Code Verification Review Requirement for 
Articulating Digit(s) and Prosthetic Hands
Manufacturers were asked to visit the PDCA website to get the coding 
verification review application. The process was easy to assist the 
suppliers and manufacturers with the correct coding. The revised 
announcement made it mandatory code verification by the PDCA 
contractor for the DME MACs (Durable Medical Equipment Medicare 
Administrative Contractors) for the upper extremity devices to qualify for 
the HCPCS codes. 
Furthermore, it was established that the only authority to have the ability 
to verify the HCPCS Level II Coding Guidelines was CMS and the DME 
MACs. This factor was specified in Chapter 3, Section 3, 3.B, and 3, 6, 
2.4 for the Medicare claims in the Centres for Medicare and Medicaid 
(CMS) Program Integrity Manual, published 100-08. In the manual, it has 
been stated that the CMS has the authority to manage and assign the 
HCPCS codes by creating, changing the code narrative, and deleting it 
under 42 CFR § 414.40 and 45 CFR § 162.1002. 
Any facility needing additional information on the billing and coding of 
HCPCS codes related to L6715 and L6880 can look up the publication 
Correct Coding.
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  Want To Ensure You Use These Correctly 
For Your Medical Billing And Coding?
All these can be pretty complicated while working on ensuring the best 
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