2025 HCPCS code L5698
(Active) Effective Date: N/A Revision Date: N/A Prosthetic Devices - Lower Extremity Prosthetic Additions Socket Insert, Suspensions, and Other Prosthetic Additions Feed
Silesian bandage for above-knee or knee disarticulation prostheses.
Modifiers may apply depending on the circumstances, such as 52 (reduced services) if the bandage is altered or a portion is not provided.Additional modifiers could include those indicating laterality (RT or LT).
Medical necessity is established by the need for a Silesian bandage to provide adequate support and stability for the prosthesis, preventing skin breakdown, improving gait, and enhancing the patient's overall functional ability.
The clinical responsibility involves supplying the appropriate Silesian bandage to the patient, ensuring proper fit and explaining its use in maintaining prosthesis stability.
In simple words: This code is for a special type of band (Silesian bandage) that helps hold a prosthetic leg in place, especially for those who have had their leg amputated above or at the knee. The band goes around the waist and attaches to the artificial leg, keeping it secure.
HCPCS code L5698 represents a Silesian bandage, a webbing band encircling the torso to support and distribute the weight of an above-knee or knee disarticulation prosthesis.It attaches to the prosthesis socket, near the hip joint and seatbones, aiding in stabilization during use with total or partial suction suspension sockets.
Example 1: A patient with a right above-knee amputation receives a new prosthesis with a total suction socket.The orthotist supplies and fits a Silesian bandage (L5698) to improve the prosthesis's stability and weight distribution., A patient with a left knee disarticulation is fitted with a partial suction socket prosthesis. A Silesian bandage (L5698) is provided to help prevent the prosthesis from shifting or rotating on the residual limb., Following revision surgery on an existing above-knee prosthesis, a new Silesian bandage (L5698) is necessary due to changes in the patient's residual limb volume and the prosthesis socket fit.
Documentation should include the type of amputation (above-knee or knee disarticulation), the type of prosthetic socket (total suction or partial suction), the reason for the Silesian bandage (e.g., improved stability, weight distribution), and confirmation that the patient was properly fitted with the bandage.
** This code is typically used in conjunction with other codes representing the prosthesis and its components.Accurate documentation is crucial for appropriate reimbursement.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier does not apply to this code as it represents a supply.
- Specialties:Prosthetics and Orthotics, Physical Medicine and Rehabilitation
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center