L6035 Insurance Policy Changes

HCPCS L6035 is officially defined as "Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement." HCPCS L6035 is referenced in 6 tracked payer policy changes from UnitedHealthcare, CareSource, and 3 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS L6035 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

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All billing codesJ35909921299213992029921199214

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