L7406, Addition to upper extremity prosthesis, user adjustable, mechanical, residualHCPCS/CPT
Prior Auth Required
At least one active policy explicitly requires prior authorization (high confidence)
EVICORE-HPLAN-CIGNA_MEDICARE-268F28B96146, Cigna Medicare Advantage Durable Medical Equipment Code List - Effective 01/01/2025
UHC-POL-upper-extremity-prosthetic-devices, Upper Extremity Prosthetic Devices
AMBETTER-CP.MP.107, Durable Medical Equipment and Orthotics and Prosthetics Guidelines
REGENCE-DME98, Mechanical Residual Limb Volume Management System for Upper Extremity Prostheses
UMR-POL-UMR-upper-extremity-prosthetic-devices, Upper Extremity Prosthetic Devices
SUREST-POL-SUREST-upper-extremity-prosthetic-devices, Upper Extremity Prosthetic Devices
Ask Backwork about documentation requirements, denial risks, or coverage in your state.