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    v1.0.28
    OpenPayerBilling CodesOrthotic Procedures and servicesHCPCS hcpcs-l0978-axillary-crutch-extension
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    HCPCS L0978: Axillary Crutch Extension

    HCPCS Level II code L0978 denotes an axillary crutch extension, a durable medical equipment accessory used to extend or adapt axillary crutches for patient mobility; this item is classified as durable medical equipment (DME) and is typically provided for outpatient, home, or community mobility needs where crutch length modification is required to achieve proper fit and function.

    For related coverage guidance, see recent payer policy updates: Interferential Stimulation Devices (for home use), Durable Medical Equipment (DME): Tumor Treating Fields (Alternating Electric Field Therapy) Medical Guideline, Durable Medical Equipment (DME): Bone Growth Stimulators Medical Guideline.

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    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old patient with chronic right-sided axillary pain and altered crutch fit after recent weight loss is evaluated in an outpatient durable medical equipment (DME) clinic. The patient uses a standard axillary crutch and reports discomfort at the armpit and difficulty achieving appropriate height and clearance. The DME clinician performs an assessment of crutch fit, measures arm length and patient height, and determines that an axillary crutch extension is required to increase overall crutch length for proper gait mechanics and weight distribution.

    The clinical workflow includes history and physical assessment by the referring provider or DME specialist; documentation of functional limitation (ambulation difficulty, fall risk); selection and ordering of the axillary crutch extension (HCPCS L0978); obtaining any necessary prior authorization from the patient’s payer; customization or installation of the extension on the existing crutch; patient education on safe use, donning/doffing, and follow-up plan; and documentation of medical necessity in the patient record tied to the appropriate ICD-10 diagnosis code(s).

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    97760Orthotic(s)/prosthetic(s) and/or shoe modification(s) (including assessment and fitting when performed) initial orthotic(s)/prosthetic(s) fitting and training, upper extremityPerformed when formal fitting and training for an upper-extremity assistive device or modification is provided alongside the crutch extension.
    97530Therapeutic activities, direct (one-on-one) patient contact by the provider, each 15 minutesUsed when a therapist provides gait training and functional mobility sessions after installation of the extension.
    99213Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutesUsed for the clinician visit documenting need, assessing function, and ordering the crutch extension.
    99070Supplies and materials (used ancillary to a procedure)Used to bill miscellaneous supplies associated with customization or padding for the extension.
    A9270Non-covered item or service (used for reporting when appropriate)May be used by some payers to indicate a non-covered accessory; billing practices vary by payer.

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    333600000XPharmacyA facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative servi…
    367500000XCertified Registered Nurse Anesthetist(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, prov…
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    207RC0000XCardiovascular Disease PhysicianAn internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threaten…
    2084A2900XNeurocritical Care PhysicianThe medical subspecialty of Neurocritical Care is devoted to the comprehensive, multisystem care of the critically-ill neurological patient. Like othe…
    101YP2500XProfessional CounselorBehavioral Health & Social Service Providers · Counselor
    2084S0012XSleep Medicine (Psychiatry & Neurology) PhysicianA Psychiatrist or Neurologist who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessme…
    207RC0200XCritical Care Medicine (Internal Medicine) PhysicianAn internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for…

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 3

    5 rows

    PolicyPayerEffective Date
    Interferential Stimulation Devices (for home use)Moda Health2026-10-01
    Durable Medical Equipment (DME): Tumor Treating Fields (Alternating Electric Field Therapy) Medical GuidelineWPS Health Insurance2026-10-01
    Durable Medical Equipment (DME): Bone Growth Stimulators Medical GuidelineWPS Health Insurance2026-10-01
    General Durable Medical Equipment (DME) Medical GuidelineWPS Health Insurance2026-10-01
    Prior Authorization for Durable Medical Equipment (DME)Blue Cross Blue Shield - Rhode Island2026-10-01

    Related Codes

    HCPCS-L0112-CRANIAL-CERVICAL-ORTHOSIS-CONGENITAL-TORTICOLLIS-CUSTOM

    HCPCS L0112: Cranial Cervical Orthosis, Congenital Torticollis Type

    HCPCS-L0113-CRANIAL-CERVICAL-ORTHOSIS-TORTICOLLIS

    HCPCS Level II L0113: Prefabricated Cranial Cervical Orthosis for Torticollis

    HCPCS-L0130-CERVICAL-FLEXIBLE-THERMOPLASTIC-COLLAR-MOLDED-TO-PATIENT

    HCPCS Level II L0130: Cervical Flexible Thermoplastic Collar, Molded to Patient

    HCPCS-L0140-CERVICAL-SEMI-RIGID-ADJUSTABLE-PLASTIC-COLLAR

    HCPCS Level II L0140: Cervical Semi-Rigid Adjustable Plastic Collar

    HCPCS-L0150-CERVICAL-SEMI-RIGID-ADJUSTABLE-CHIN-CUP

    HCPCS Level II L0150: Cervical Semi-Rigid Adjustable Chin Cup

    HCPCS-L0160-CERVICAL-SEMI-RIGID-OCCIPITAL-MANDIBULAR-SUPPORT

    HCPCS Level II L0160: Cervical Semi-Rigid Occipital/Mandibular Support

    HCPCS-L0170-CERVICAL-COLLAR-MOLDED-TO-PATIENT-MODEL

    HCPCS Level II L0170: Cervical Collar, Custom-Molded

    HCPCS-L0172-CERVICAL-COLLAR-SEMI-RIGID-THERMOPLASTIC-FOAM

    HCPCS L0172: Cervical Collar, Semi-Rigid Prefabricated

    HCPCS-L0174-CERVICAL-COLLAR-SEMI-RIGID-THORACIC-EXTENSION

    HCPCS L0174: Cervical Collar, Semi-Rigid Thermoplastic with Thoracic Extension

    HCPCS-L0180-CERVICAL-MULTIPLE-POST-COLLAR-OCCIPITAL-MANDIBULAR-ADJUSTABLE

    HCPCS Level II L0180: Cervical Orthosis with Occipital/Mandibular Supports

    Showing 1–10 of 466

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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