2025 HCPCS code L5701
(Active) Effective Date: N/A Revision Date: N/A Prosthetic Procedures - Replacement Sockets Orthotics and Prosthetics Feed
Supply of a molded replacement socket for an above-knee or knee disarticulation amputation prosthesis, including the attachment plate.
Modifiers may apply depending on the circumstances (e.g., 52 for reduced services, RT/LT for laterality, etc.).
Medical necessity is established by documentation demonstrating that the existing socket is no longer suitable due to changes in the patient's residual limb size or shape, resulting in discomfort, skin breakdown, or compromised prosthetic function.The replacement socket is necessary to restore proper prosthetic function and improve the patient's quality of life.
The clinical responsibility involves taking precise measurements and molds of the patient's residual limb to create a custom-fit socket.The prosthetist or orthotist is responsible for the fabrication, fitting, and adjustment of the socket to ensure proper alignment and comfort.
In simple words: This code covers the cost of a new, custom-made socket for a leg prosthesis after an above-knee or knee amputation. The socket is made to fit the patient's leg precisely and attaches to the artificial leg.It may include padding for comfort.
This code represents the supply of a custom-fabricated, molded replacement socket for an above-knee or knee disarticulation amputation prosthesis.The socket is molded to the patient's residual limb for a precise fit and attaches to an above-knee or knee disarticulation prosthesis. It may include a pad or liner to enhance patient comfort.Since the residual limb may have changed in size and shape, the new socket is created using molds made from the patient's body.The code includes the supply of the attachment plate.
Example 1: A patient with an above-knee amputation, whose residual limb has shrunk significantly since their initial prosthesis was fitted, requires a replacement socket for a better fit and improved comfort., A patient with a knee disarticulation amputation experiences discomfort and skin irritation due to changes in their residual limb. A replacement socket is necessary to alleviate these issues and restore proper prosthetic function., Following a revision surgery on a patient's above-knee amputation, the original socket no longer fits properly. A new socket needs to be fabricated to accommodate the changes in the residual limb resulting from the surgery.
Detailed measurements and molds of the patient's residual limb,specifications of the prosthesis, and documentation supporting the medical necessity for the replacement socket (e.g., physician's order, clinical notes).
** Consider using additional modifiers for specific circumstances, such as those indicating whether the item was new or used when rented.
- Payment Status: Active
- Specialties:Prosthetics, Orthotics, Physical Medicine and Rehabilitation
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center