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    v1.0.31
    OpenPayerBilling CodesProsthetic ProceduresHCPCS hcpcs-l5705-custom-shaped-protective-cover-above-knee
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    HCPCS L5705: Custom Shaped Protective Cover, Above Knee

    HCPCS Level II code L5705 describes a custom-shaped protective cover for the limb, specified as an above-knee device; the service is the provision and fitting of a custom protective cover and the typical site of service is outpatient clinic or durable medical equipment (DME) supplier settings where custom limb protective devices are measured and fitted.

    For related coverage guidance, see recent payer policy updates: Speech Therapy for Autism Disorders - Medical Policy, Physical Performance Test or Measurement, Sensory Integration Therapy and Auditory Integration Training.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult recovering from above-knee surgery (e.g., total knee arthroplasty with an extended incision, traumatic femoral laceration, or soft-tissue reconstruction) who requires a custom-shaped protective cover to shield the operative site and dressing during ambulation or wound healing. The device, billed as L5705 (custom shaped protective cover, above knee), is fabricated to fit the patient’s residual limb geometry or surgical dressing contours and is applied in the outpatient orthopedics or durable medical equipment (DME) workflow.

    The clinical workflow: the orthopedic surgeon or wound care clinician documents the need for a protective cover in the post-operative visit or wound clinic note, specifying above-knee location and rationale (e.g., protect incision, permit showering, prevent contact with clothing). A DME supplier does measurement and custom fabrication, coordinates delivery, and provides patient education on use and precautions. The supplier bills L5705 to the patient’s payor with appropriate modifiers (for laterality, services rendered, or special circumstances) and maintains documentation of medical necessity, measurements, and supplier notes in the patient record.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    97001Physical therapy evaluationInitial functional assessment that may identify need for protective device post-operatively
    29515Application of multi-layer compression system; unilateral below knee (e.g., for wound management)May be performed before or in conjunction with fitting to manage edema and dressing profile prior to custom cover fabrication
    11043Debridement, subcutaneous tissue, muscle and fascia (e.g., wound debridement)Surgical or clinical wound management that precedes need for a custom above-knee protective cover
    97035Ultrasound (therapeutic)Post-operative therapy that may occur in same care episode where protective covering is indicated
    99070Supplies and materials (e.g., dressings, splints) used in the clinicSupplies related to dressing protection which complement the custom protective cover

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    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…
    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…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    47Modifier -47 (“Anesthesia by Surgeon”) is appended to a surgical or procedural CPT code when the surgeon personally provides regional or general anesthesia for the procedure. Use of -47 indicates the…- Use modifier -47 when the surgeon personally provides regional or general anesthesia during the surgical procedure (i.e., the surgeon administers the anesthesia in addition to performing the…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207L00000X
    332B00000X
    3336C0002X
    2080P1004X
    207QP0002X
    207RA0002X
    2084H0002X
    156FC0800X

    Related Payer Policy Updates

    Specialty: Physical Medicine, Rehab & Therapies1 / 2

    10 rows

    PolicyPayerEffective Date
    Speech Therapy for Autism Disorders - Medical PolicyHealth-New-England2026-12-01
    Physical Performance Test or MeasurementCigna2026-11-15
    Sensory Integration Therapy and Auditory Integration TrainingColorado Rocky Mountain Health Plans2026-11-01
    Skilled Nursing and Skilled Rehabilitation Services (Outpatient)Anthem2026-10-01
    Habilitation and Rehabilitation Therapy (Occupational, Physical, and Speech) (for New Mexico Only)UnitedHealthcare2026-10-01
    Physical Therapy/Medicine Corporate Medical Policybcbsvermont2026-10-01
    Cognitive Rehabilitation Corporate Medical Policybcbsvermont2026-10-01
    Speech Language Pathology/Therapy Services Corporate Medical Policybcbsvermont2026-10-01
    Occupational Therapy Corporate Medical Policybcbsvermont2026-10-01
    Biomagnetic TherapyConnectiCare2026-09-11

    Related Codes

    HCPCS-L5000-PARTIAL-FOOT-SHOE-INSERT-LONGITUDINAL-ARCH-TOE-FILLER

    HCPCS Level II L5000: Partial Foot Shoe Insert with Longitudinal Arch, Toe Filler

    HCPCS-L5010-PARTIAL-FOOT-MOLDED-SOCKET-ANKLE-HEIGHT-TOE-FILLER

    HCPCS L5010: Partial Foot Molded Socket, Ankle Height, With Toe Filler

    HCPCS-L5020-PARTIAL-FOOT-MOLDED-SOCKET-TIBIAL-TUBERCLE-TOE-FILLER

    HCPCS L5020: Partial Foot Molded Socket with Toe Filler

    HCPCS-L5050-ANKLE-SYMES-MOLDED-SOCKET-SACH-FOOT

    HCPCS L5050: Ankle/Symes Molded Socket with SACH Foot

    HCPCS-L5060-ANKLE-SYMES-METAL-FRAME-MOLDED-LEATHER-SOCKET-ARTICULATED-ANKLE-FOOT

    HCPCS L5060: Ankle/Symes Metal Frame with Molded Leather Socket

    HCPCS-L5100-BELOW-KNEE-MOLDED-SOCKET-SHIN-SACH-FOOT

    HCPCS Level II L5100: Below-Knee Molded Socket with Shin and SACH Foot

    HCPCS-L5105-BELOW-KNEE-PLASTIC-SOCKET-SACH-FOOT

    HCPCS L5105: Below-Knee Plastic Socket Prosthesis with SACH Foot

    HCPCS-L5150-KNEE-DISARTICULATION-MOLDED-SOCKET-EXTERNAL-KNEE-SACH-FOOT

    HCPCS L5150: Knee Disarticulation Molded Socket with External Knee and SACH Foot

    HCPCS-L5160-KNEE-DISARTICULATION-MOLDED-SOCKET-BENT-KNEE-SACH-FOOT

    HCPCS Level II L5160: Knee Disarticulation Molded Socket, Bent Knee Configuration

    HCPCS-L5200-ABOVE-KNEE-MOLDED-SOCKET-SINGLE-AXIS-KNEE-SACH-FOOT

    HCPCS Level II L5200: Above-knee Prosthesis with Molded Socket and Single-axis Knee

    Showing 1–10 of 472

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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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