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    v1.0.31
    OpenPayerBilling CodesProsthetic ProceduresHCPCS hcpcs-l5814-endoskeletal-knee-shin-polycentric-hydraulic-swing-lock
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    HCPCS L5814: Endoskeletal Polycentric Knee-Shin Addition with Hydraulic Swing Control

    HCPCS Level II code L5814 describes an addition to an endoskeletal knee-shin prosthetic system featuring a polycentric knee with hydraulic swing phase control and a mechanical stance phase lock; this component is used as a lower-limb prosthetic knee joint addition (prosthetic component) for patients with transfemoral or knee-disarticulation amputations, typically fitted in outpatient prosthetics clinics or prosthetist workshops and used during ambulation to provide controlled swing-phase motion and stance stability.

    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 58-year-old male transtibial amputee with a long-standing above-knee weakness on the contralateral limb presents for prosthetic knee component upgrade to improve gait stability and energy efficiency. The treating prosthetist and orthotist team evaluate the residual limb, alignment, and functional K-level. The patient demonstrates adequate limb volume, healed residual limb tissues, and ambulates household to community distances but exhibits knee instability during swing and inconsistent stance control on uneven surfaces. After multidisciplinary review, the team prescribes an endoskeletal polycentric knee-shin system with hydraulic swing phase control and a mechanical stance phase lock to address controlled knee flexion during swing and reliable stance stability.

    The clinical workflow includes: referral from a physical medicine and rehabilitation physician; pre-prosthetic assessment by a certified prosthetist; measurement and casting or scanning of the residual limb; fabrication and bench alignment of the endoskeletal knee-shin assembly; component fitting and dynamic alignment trial; gait training with a physical therapist; final adjustments and patient education on donning, maintenance, and precautions; and final delivery with documentation of functional outcome and justification for the specific knee features. Billing for the addition of the knee-shin system uses HCPCS code L5814 with applicable modifiers to indicate laterality, prosthesis type, or payer-specific reporting requirements.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    97760Orthotic management and training, upper or lower extremity, initial encounter, each 15 minutesUsed for prosthetic/orthotic training sessions during initial fitting and gait training
    97761Prosthetic training, upper and/or lower extremity, subsequent encounters, each 15 minutesBilled for follow-up prosthetic training visits after initial fitting
    97110Therapeutic exercises to develop strength and endurance, each 15 minutesCommonly billed by physical therapists during gait and strengthening programs after component fitting
    97001Data not available in the input.Data not available in the input.
    99070Supplies and materials (e.g., replacement parts), used for patient care, not included in serviceCan be used to bill consumable components, padding, or replacement parts associated with the prosthesis

    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…
    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…
    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…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    332B00000X
    207L00000X
    207RH0000X
    207RG0300X
    2278P3900X
    133VN1005X
    2355S0801X
    213EP0504X

    Related ICD-10-CM Codes

    21 rows

    ICD-10-CM CodeDescription
    M17.0Bilateral primary osteoarthritis of knee
    M17.11Unilateral primary osteoarthritis, right knee
    M17.12Unilateral primary osteoarthritis, left knee
    M17.2Bilateral post-traumatic osteoarthritis of knee
    M17.4Other bilateral secondary osteoarthritis of knee
    M17.5Other unilateral secondary osteoarthritis of knee
    M17.9Osteoarthritis of knee, unspecified
    M23.8X1Other internal derangements of right knee
    M24.271Disorder of ligament, right ankle
    M24.272Disorder of ligament, left ankle

    Showing 1–10 of 21

    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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