Lower Limb Prostheses
National · Effective Apr 1, 2026
1 active Medicare policy lists L5781, and 9 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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National · Effective Apr 1, 2026
9 policies from 8 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of L5781 |
|---|---|---|
| Cigna Commercial DME Code List - Effective 03/07/2026 | Mar 7, 2026 | Prior auth required |
| Cigna Comprehensive Code List - Effective 03/07/2026 | Mar 7, 2026 | Prior auth required |
| Policy | Effective | Status of L5781 |
|---|---|---|
| Prosthetic Limb Vacuum Systems | Sep 13, 2023 | Covered |
| Policy | Effective | Status of L5781 |
|---|
| Lower Limb Prosthesis | Oct 1, 2024 | Covered |
|---|
| Policy | Effective | Status of L5781 |
|---|---|---|
| Lower-Limb Prosthetics, Including Microprocessor-Controlled Prosthetics | Jan 1, 2026 | Covered |
| Policy | Effective | Status of L5781 |
|---|---|---|
| Lower-Limb Prosthetics, Including Microprocessor-Controlled Prosthetics | Jan 1, 2026 | Covered |
| Policy | Effective | Status of L5781 |
|---|---|---|
| Lower-Limb Prosthetics, Including Microprocessor-Controlled Prosthetics | Jan 1, 2026 | Covered |
| Policy | Effective | Status of L5781 |
|---|---|---|
| Lower-Limb Prosthetics, Including Microprocessor-Controlled Prosthetics | Jan 1, 2026 | Covered |
| Policy | Effective | Status of L5781 |
|---|---|---|
| Cigna Medicare Advantage Durable Medical Equipment Code List - Effective 01/01/2025 | Jan 1, 2025 | Prior auth required |