L5704 Custom shaped protective cover, below knee
Billable / valid for submission HCPCS Release 2026Q3
Short description: Custom shape cover bk
Version history
| Release | Valid from | Valid to | Description | Billable |
|---|---|---|---|---|
| 2026Q3 | 2026-07-01 | current | Custom shaped protective cover, below knee | yes |
Related codes in L57
- L5700 Replacement, socket, below knee, molded to patient model
- L5701 Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model
- L5702 Replacement, socket, hip disarticulation, including hip joint, molded to patient model
- L5703 Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only
- L5705 Custom shaped protective cover, above knee
- L5706 Custom shaped protective cover, knee disarticulation
- L5707 Custom shaped protective cover, hip disarticulation
- L5710 Addition, exoskeletal knee-shin system, single axis, manual lock
- L5711 Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material
- L5712 Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)
- L5714 Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control
- L5716 Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock
- L5718 Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control
- L5722 Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control
- L5724 Addition, exoskeletal knee-shin system, single axis, fluid swing phase control
- L5726 Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control
- L5728 Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control
- L5780 Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control
- L5781 Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system
- L5782 Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty