ANEST_BU
0
BETOS
D1F
Long Description
Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)
Category
COV
C
HCPCS
L6696
MULT_PI
A
PRICE1
38.00
RECID
3
SEQNUM
0010
SHORT DESCRIPTION
Cus elbo skt in for con/atyp
TOS1
P