HCPCS Range Hand Restoration Prosthetics and Additions

• 1 Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment ( L6890 )

• 2 Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated ( L6895 )

• 3 Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining ( L6900 )

• 4 Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining ( L6905 )

• 5 Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining ( L6910 )

• 6 Hand restoration (shading, and measurements included), replacement glove for above ( L6915 )