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    v1.0.28
    OpenPayerBilling CodesOrthotic Procedures and servicesHCPCS hcpcs-l3995-upper-extremity-orthosis-sock-fracture-addition
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    HCPCS L3995: Addition to Upper Extremity Orthosis, Sock, Fracture

    HCPCS Level II code L3995 describes an addition to an upper extremity orthosis: a sock used for fracture or equivalent; this is an orthotic supply item intended to be used with an upper limb brace or splint. The service type is orthotic accessory supply, and the typical site of service is outpatient orthotics/prosthetics clinics, durable medical equipment providers, or hospital outpatient departments where orthoses are fitted and supplied.

    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 patient presents to an outpatient orthopedic clinic after sustaining a distal radius fracture of the dominant wrist in a fall. The fracture has been reduced and immobilized in a temporary splint. The treating orthopedic clinician or certified orthotist prescribes a removable upper extremity fracture orthosis with an accessory sock (cover) for padding, hygiene, or pressure redistribution. The orthotist measures the patient, fits an appropriate prefabricated or custom-molded orthosis, and adds L3995 as the line-item charge for the additional sock component supplied with the orthosis. Typical workflow includes evaluation, measurement and fitting, patient instruction on wear and care, and documentation of medical necessity and delivery. Typical sites of service are outpatient orthopedic clinics, ambulatory surgery centers (when dispensed post-procedure), and durable medical equipment supplier locations where upper-extremity orthoses are dispensed and adjusted.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    29105Application of short arm splint (forearm to hand), staticOften performed in the immediate management of distal forearm/ wrist fractures prior to definitive orthosis fitting; may precede dispensing of an orthosis sock
    97602Removal of devitalized tissue from wound, selective debridement, without anesthesia (Note: typically not related)Not directly related to orthosis sock; Data not applicable
    97760Orthotic management and training, upper extremity, initial encounterPerformed alongside dispensing of an orthosis and accessories to document fit, training, and functional use
    99070Supplies and materials (e.g., bandages, splints) provided by the physician over and above those usually included in the office visitMay be used for billing minor supplies, but L3995 specifically describes the sock accessory as a HCPCS DME addition
    A9270Noncovered item or service (Note: HCPCS Level II)Not a CPT code; included here for supply context

    Related Modifiers

    5 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…
    58Modifier 58 (Staged or related procedure/service by the same physician during the postoperative period) indicates that a subsequent procedure performed by the same provider during the…- Use modifier 58 when the same physician/QHP performs a procedure during the postoperative/global period of an earlier procedure and the subsequent procedure is either planned or anticipated…
    3PThe CPT Category II modifier -3P denotes a performance‑measure exclusion when a required quality action was not performed because of system‑level constraints. It is appended only to Category II…- When to apply: Use CPT Category II modifier 3P only with Category II (‘‘F’’) codes when a specific quality measure’s specifications allow a system‑level exclusion — append 3P to indicate the…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    235Z00000XSpeech-Language PathologistThe speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in…
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    163WC0200XCritical Care Medicine Registered NurseNursing Service Providers · Registered Nurse
    3416S0300XWater AmbulanceTransportation Services · Ambulance
    1223X2210XOrofacial Pain DentistryA dentist who assesses, diagnoses, and treats patients with complex chronic orofacial pain and dysfunction disorders, oromotor and jaw behavior disord…
    111NR0400XRehabilitation ChiropractorRehabilitation is the discipline focused on restoring a patient's functional abilities to pre-injury or pre-disease status. Functional abilities are d…
    363A00000XPhysician AssistantA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
    2088F0040XUrogynecology and Reconstructive Pelvic Surgery (Urology) PhysicianA subspecialist in Urogynecology and Reconstructive Pelvic Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education …

    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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