HCPCS Code: |
L8001 |
Long Description: |
Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type |
Short Description: |
Breast prosthesis bra & form |
Pricing Indicator 1: |
38 (Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings)) |
Multiple Pricing Code: |
A (Not applicable as HCPCS priced under one methodology) |
MCM Reference Section Number 1: |
2130A |
Statute Number: |
|
Coverage Code: |
D (Special coverage instructions apply) |
ASC Payment Group Code: |
|
Processing Note Number: |
|
Berenson-Eggers Type of Service (BETOS) Code: |
D1F (Orthotic devices) |
Type of Service Code 1: |
P (Lump sum purchase of DME, prosthetics, orthotics) |
Anesthesia Base Unit Quality: |
0 |
Code Added: |
01-01-2002 |
Action Effective Date: |
01-01-2013 |
Action Code: |
N (No maintenance for this code) |