In simple words: This code covers the first custom-made, gel or rubber-like liner that goes inside the socket of a leg prosthesis, between the skin and the artificial limb. It's used for amputations either above or below the knee.

This code represents the initial supply of a custom fabricated socket insert liner made of silicone gel or similar elastomeric material for a lower extremity prosthesis, either below or above the knee. It can be used with or without a locking mechanism. This code is not applicable for patients with congenital limb absence or atypical traumatic amputations.

Example 1: A patient with a below-knee amputation receives their first custom silicone gel socket insert for their new prosthesis., A patient with an above-knee amputation requires a custom elastomeric socket insert with a locking mechanism for their prosthesis. This is the initial fitting of this device., An individual receives a new lower extremity prosthesis after an amputation due to an accident. A custom silicone gel socket insert liner is provided as part of the initial fitting.

Documentation should support the medical necessity of a custom-fabricated socket insert and clearly indicate that this is the initial provision of the insert. The type of material (silicone gel, elastomeric, or equal) should also be documented. The amputation level (above or below knee) should be specified, along with whether or not a locking mechanism is used.