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    v1.0.31
    OpenPayerBilling CodesProsthetic ProceduresHCPCS hcpcs-l7400-upper-extremity-ultralight-prosthesis-addition
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    HCPCS L7400: Addition to Upper Extremity Prosthesis, Ultralight

    HCPCS Level II code L7400 describes an addition to an upper extremity prosthesis for below-elbow or wrist disarticulation amputation, specifying an ultralight material option such as titanium or carbon fiber; it represents a prosthetic component or upgrade used in upper limb prosthetics fabrication or modification and is typically provided in a prosthetics clinic or orthotics and prosthetics provider setting for patients receiving a below-elbow/wrist-disarticulation prosthesis.

    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 42-year-old male with a transradial (below-elbow) amputation from a traumatic industrial accident presents to a prosthetics clinic for fabrication and fitting of a definitive prosthesis. The limb has a healed residual limb with stable soft tissues and a well-formed socket interface. The patient is an active manual laborer seeking a lightweight terminal device and wrist unit to improve function and reduce proximal shoulder strain.

    The prosthetist performs a comprehensive evaluation, takes measurements and casting or digital scans of the residual limb, and determines that an ultralight structural addition fabricated from titanium or carbon fiber is appropriate to reduce distal weight and improve device control. The clinic documents the medical necessity, functional goals, and details of the material selection and prepares the order for the addition to the patient’s existing below-elbow prosthesis. The fabrication occurs in a contracted orthotics and prosthetics lab; the clinic completes delivery, alignment, training, and follow-up care. Billing uses the HCPCS Level II code L7400 to report the ultralight material addition to an upper extremity below-elbow/wrist disarticulation prosthesis.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    97760Orthotic(s) management and training, initial encounter, each 15 minutesUsed for training the patient in use of the new ultralight prosthetic component and related donning/doffing and care.
    97763Orthotic/prosthetic management and training, direct patient contact, new prosthesis, initial encounterUsed for comprehensive training and fitting of a new prosthesis that includes additions such as ultralight components.
    97762Orthotic management and training, subsequent encounterUsed for follow-up training and adjustments after initial fitting of the new addition.
    99070Supplies and materials (used when not included in the prosthetic allowance)Used to bill non-covered supplies or additional materials associated with fabrication when permitted by payer.
    S1040Prosthetic device, upper extremity, body-powered, partial hand/hand/forearm, includes fitting and any related additions (varies by payer)Used by some suppliers in conjunction with component additions; verify payer-specific coding for HCPCS and CPT crosswalk.

    If a payer requires specific CPT-level documentation for professional services related to prosthetic fitting, the above codes are commonly used in the clinical workflow surrounding an L7400 fabrication and fitting.

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    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…
    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…
    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…
    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…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    2080P0207X
    213E00000X
    2088F0040X
    2279P4000X
    2080P0216X
    207V00000X
    3336M0002X
    207ZC0006X

    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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