The Centers for Medicare & Medicaid Services (CMS) established new Healthcare Common Procedure Coding System (HCPCS) Level II codes for partial hand and finger prostheses, effective April 1.
L-6037 was assigned for post-surgical fittings; L-6028 is the new base code for partial hand prostheses.
Chris Baschuk, CPO, Point Designs, led the coding submission and collaborated with stakeholders, including manufacturers and the O&P Alliance, to ask CMS for the changes.
“We are thrilled with CMS’ decision to create distinct codes for partial hand and finger prostheses,” said Baschuk. “This is a win for patients and clinicians alike, as it not only validates the specialized clinical work involved but also lays the groundwork for equitable access to these transformative devices.”
Point Designs said that the revised and new codes address gaps in the HCPCS system by accurately describing the distinct components and fabrication processes essential for partial hand and finger prostheses. Existing codes now include broader applicability, allowing for the inclusion of locking mechanisms for partial hand prostheses.
To read the section of the CMS document, “Centers for Medicare & Medicaid Services’ (CMS’) Healthcare Common Procedure Coding System (HCPCS) Level II Final Coding, Benefit Category and Payment Determinations Second Biannual (B2), 2024 HCPCS Coding Cycle,” see page 163.
