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2025 HCPCS code L6925

Externally powered prosthetic device for wrist disarticulation, with a self-suspended inner socket, removable forearm shell, myoelectronic control, and necessary components (electrodes, cables, batteries, charger).

Modifiers such as LT (left side) and RT (right side) can be used to specify the affected limb.

Medical necessity must be established for coverage. This generally requires documentation demonstrating a loss of function due to amputation and a need to restore some degree of function in activities of daily living using the prosthetic device.

In simple words: This is a code for a powered artificial hand and wrist for someone who has had their hand and wrist amputated. It's held in place by suction and has a cover for the lower arm. The artificial hand is controlled by the user's muscles through sensors, and it comes with batteries and a charger.

Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, Otto Bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device. This code covers an externally powered prosthetic device for individuals with wrist disarticulation. The prosthesis utilizes a self-suspended inner socket and a removable forearm shell. It includes Otto Bock or equivalent electrodes, cables, two batteries, a charger, and features myoelectronic control of the terminal device.

Example 1: A patient with a left wrist disarticulation resulting from a traumatic injury requires an externally powered prosthesis with myoelectric control for improved functionality and restoration of activities of daily living. Code L6925-LT is used., A patient with a right wrist disarticulation due to complications from diabetes requires a prosthesis that allows for precise movements. The patient opts for the myoelectrically controlled device with a self-suspended socket for better comfort and control. Code L6925-RT is used., Following a revision amputation at the wrist level, a patient's existing prosthesis needs replacement. They choose an updated model with myoelectronic control and a self-suspended socket, as described by code L6925.

Documentation should support the medical necessity of the prosthesis, including the specific level of amputation (wrist disarticulation), the patient's functional limitations, and the expected benefits of the device. Details about the chosen components (e.g., myoelectric control, self-suspended socket) should also be recorded.

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