Important Update – Upper Extremity Prosthetic Myoelectronic Control: Coding & Verification Requirements 

The DME MACs and PDAC have jointly published important updates regarding the use of HCPCS code L6700, which pertains to external powered myoelectronic control modules with pattern recognition used in upper extremity prosthetics. These changes, effective for claims with dates of service on or after July 1, 2025, are intended to clarify proper coding and enforce coding verification requirements. 

What You Need to Know

HCPCS code L6700 describes a distinct, separately billable component of a myoelectric-controlled upper extremity prosthesis. Specifically, this code applies to an external powered myoelectronic control module that meets certain technical requirements. To qualify, the product must have the capability to gather, decode, and integrate signals from at least three electromyographic sites. It must also incorporate machine learning algorithms that can recognize and simultaneously decode complex EMG patterns, allowing the system to determine a user’s movement intent in real time. This intent is then translated into command signals to drive motion in prosthetic components such as terminal devices, wrists, or elbows. 

You should only use L6700 for products that represent a distinct and separate physical module—not for embedded or bundled features. The correct unit of service is one per limb. Using miscellaneous codes like L7499 to describe features already captured under L6700 is considered incorrect and constitutes unbundling. Only those products that are specifically listed under L6700 on the PDAC’s Product Classification List are eligible for billing using this code. 

 What This Means for You

Beginning July 1, 2025, all claims submitted under HCPCS code L6700 must meet new coding verification requirements. This means that only products listed on the PDAC Product Classification List under code L6700 will be eligible for reimbursement. As you work with patients who require this technology, it is important to confirm the prosthetic components you recommend, document, and bill are accurately classified and meet these coding requirements. 

When submitting claims to Medicare, incorrect use of code L6700—such as applying it to unlisted or non-compliant products—may lead to denied claims. Taking time now to review product classifications and coding practices will help support a smooth and compliant transition ahead of the July 1 implementation date. 

Click here to read the complete PDAC article.