In simple words: This code covers a custom-made, gel-like insert that goes between the prosthetic socket and the skin of a below-elbow or above-elbow amputee (excluding congenital or atypical amputations) to provide cushioning and improve the fit, for the initial fitting only.

This code covers the initial supply of a custom-fabricated silicone gel, elastomeric, or equivalent socket insert for a below-elbow or above-elbow prosthesis for patients other than those with congenital or atypical traumatic amputations. The insert is compatible with sockets regardless of a locking mechanism.

Example 1: A patient with a recent above-elbow amputation receives a custom-fabricated silicone gel socket insert for their new prosthesis to improve comfort and fit during the initial fitting., A patient with a below-elbow amputation requires an initial custom-made elastomeric socket insert for their prosthesis, which has a locking mechanism., An individual with a below-elbow amputation, but not due to a congenital condition or atypical trauma, is fitted with their first prosthesis and requires a custom-fabricated socket insert made of silicone gel for optimal comfort.

Documentation should include the type of amputation (below-elbow/above-elbow), the material of the socket insert (silicone gel, elastomeric, or equivalent), the presence or absence of a locking mechanism, and confirmation that this is the initial custom fitting of the insert.