Coding Update for Prosthetic Foot
What You Need to Know
The Pricing, Data Analysis and Coding (PDAC) contractor has verified Ossur's Pro-Flex Terra for the following codes effective July 22, 2026:
- L5987 – Shank foot system with vertical loading pylon
- L5986 – Multi-axial rotation unit
What This Means for You
PDAC verification of a device confirms that the product meets the coding requirements for the verified code(s). If a supplier bills Medicare using different codes for a device than those verified by PDAC, Medicare will deny payment of those codes.
Pro-Flex Terra's PDAC verification took effect on July 22, 2026. For Pro-Flex Terras provided on or after this date you should therefore use L5987 and L5986.
For claims submitted by independent O&P facilities billing the Veterans Administration, providers no longer need to request a “Prosthetic Limb Exception” (PLE) for the Pro-Flex Terra. They should bill using the PDAC-verified codes.
To avoid claims-related issues for Pro-Flex Terra, providers should review:
- Pending claims;
- Prior authorization requests;
- Coding and billing templates;
- Product coding resources; and
- Internal billing workflows.
Updating these resources will help ensure alignment with the current PDAC verification.
The PDAC letter for Pro-Flex Terra can be found here.