Summary & Overview
HCPCS L6628: Upper Extremity Quick-Disconnect Hook Adapter
HCPCS Level II code L6628 identifies a prosthetic accessory: an upper extremity quick-disconnect hook adapter (Otto Bock or equivalent). Nationally, this code matters because it standardizes billing for a commonly used prosthetic terminal device adapter that affects coverage determinations, supplier reimbursements, and patient access to prosthetic components. Payors commonly engaged in coverage for such prosthetic accessories include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn the clinical and billing context for L6628, including the typical service setting (durable medical equipment and prosthetics/orthotics clinics), the nature of the device (adapter for hook-type terminal devices), and how the code is used in claims for prosthetic fittings and supplies. The publication provides benchmarks and policy-relevant information where available, summarizes payer approaches to coverage and claim adjudication, and outlines common modifiers and administrative considerations tied to prosthetic accessory billing. Data not available in the input will be noted where specific payer rates, taxonomies, ICD-10 pairings, or related codes are not provided.
Billing Code Overview
HCPCS Level II code L6628 describes an upper extremity addition: quick disconnect hook adapter, Otto Bock or equal. This item is an accessory component used with upper-limb prosthetic devices to provide a quick-disconnect connection for a hook terminal device. The service type is prosthetic accessory supply and fitting, and the typical site of service is durable medical equipment suppliers, prosthetics/orthotics clinics, or outpatient prosthetics fittings.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 45-year-old patient with a transradial amputation of the right forearm presents to a prosthetics clinic for fitting and functional optimization of a body-powered prosthesis. The prosthetist evaluates socket fit and terminal device compatibility and determines that an upper-extremity quick-disconnect hook adapter (e.g., Otto Bock or equal) is required to permit rapid interchange of terminal devices for activities of daily living and work tasks. The patient is fitted with the adapter, the prosthetist performs alignment checks, demonstrates attachment/detachment of the hook, and documents component serial numbers and function. The device is dispensed on the same visit with patient education on use and routine maintenance. Typical sites of service include outpatient prosthetics clinics, durable medical equipment providers, and rehabilitation hospitals where prosthetic component dispensing and adjustments are performed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Unspecified | Rarely used; not recommended for claims where a defined modifier applies |
11 | Professional component | Use when reporting the professional component of a service if applicable (e.g., provider evaluation separate from equipment billing) |