Summary & Overview
HCPCS L2425: Disc or Dial Lock for Adjustable Knee Flexion
HCPCS Level II code L2425 denotes an addition to a knee joint: a disc or dial lock for adjustable knee flexion, billed per joint. Nationally, this code matters because it captures charges for a specific prosthetic/orthotic component that affects mobility, device functionality, and the overall cost of lower-limb prosthetic care. Accurate use of L2425 supports claims processing, device inventory tracking, and clinical documentation of prosthetic fittings or adjustments.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines payer coverage patterns and typical billing practices for prosthetic knee components and provides context for clinicians, billing professionals, and policy teams managing durable medical equipment claims.
Readers will learn what L2425 represents clinically, where the service is typically delivered, and which payers commonly adjudicate these claims. The report highlights benchmarks and coding considerations, summarizes relevant policy updates where available, and situates L2425 within the prosthetics and orthotics service line. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code L2425 describes an addition to a knee joint — specifically a disc or dial lock component used to provide adjustable knee flexion, billed per joint. This item is an orthopedic device accessory intended to modify or enhance the flexion control of a prosthetic or orthotic knee joint.
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Service type: Durable medical equipment accessory / prosthetic/orthotic component
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Typical site of service: Orthotics and prosthetics clinics, outpatient surgical centers, and other ambulatory care settings where prosthetic or orthotic devices are fitted or adjusted.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a history of knee instability, prior knee arthroplasty, or a complex knee brace needing an adjustable flexion stop. The orthopedic or prosthetics clinic evaluates a patient who presents with restricted knee range of motion, instability in flexion, or component failure of an existing adjustable knee joint on a custom or prefabricated orthosis. The clinician documents the need to add a disc or dial lock to the adjustable knee flexion mechanism to limit or lock knee flexion at a specific angle.
The clinical workflow includes: initial assessment by an orthopedic surgeon or certified prosthetist/orthotist; measurement of knee range of motion and functional needs; selection of the appropriate disc or dial lock device (L2425) sized for the existing knee joint; ordering the HCPCS L2425 as an addition to the knee joint; fabrication or modification by the orthotics technician; fitting appointment to adjust and verify the lock setting; and documentation of medical necessity, device serial numbers, supplier information, and any payer-required supporting clinical notes.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | When the addition is applied to the left knee joint |