Talk to Us

Blue Cross and Blue Shield of Illinois policy

Myoelectric Prosthetic and Orthotic Components for the Upper Limb

Myoelectric Prosthetic and Orthotic Components for the Upper Limb is a public Blue Cross and Blue Shield of Illinois policy (policy DME104.001, effective Jun 15, 2026). It lists 48 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.

View the original policy (PDF) ↗

Payer
Blue Cross and Blue Shield of Illinois
Policy number
DME104.001
Effective
Jun 15, 2026
Line of business
Commercial, Medicaid
Source
medicalpolicy.hcsc.com

Codes in this policy

The CPT and HCPCS codes the policy names. A policy can name a code it excludes.

CodeOther Blue Cross and Blue Shield of Illinois policies
A8005Policies naming A8005
A8006Policies naming A8006
L6026Policies naming L6026
L6611Policies naming L6611
L6621Policies naming L6621
L6646Policies naming L6646
L6648Policies naming L6648
L6700Policies naming L6700
L6715Policies naming L6715
L6880Policies naming L6880
L6881Policies naming L6881
L6882Policies naming L6882
L6883Policies naming L6883
L6884Policies naming L6884
L6885Policies naming L6885
L6920Policies naming L6920
L6925Policies naming L6925
L6935Policies naming L6935
L6940Policies naming L6940
L6945Policies naming L6945
L6950Policies naming L6950
L6955Policies naming L6955
L6960Policies naming L6960
L6965Policies naming L6965
L6970Policies naming L6970
L6975Policies naming L6975
L7007Policies naming L7007
L7008Policies naming L7008
L7009Policies naming L7009
L7040Policies naming L7040
L7045Policies naming L7045
L7170Policies naming L7170
L7180Policies naming L7180
L7181Policies naming L7181
L7185Policies naming L7185
L7186Policies naming L7186
L7190Policies naming L7190
L7191Policies naming L7191
L7259Policies naming L7259
L7360Policies naming L7360
L7362Policies naming L7362
L7364Policies naming L7364
L7366Policies naming L7366
L7367Policies naming L7367
L7368Policies naming L7368
L7499Policies naming L7499
L8701Policies naming L8701
L8702Policies naming L8702

All Blue Cross and Blue Shield of Illinois policies

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.

This website uses cookies to ensure you get the best experience on our website. Learn more