Question 1

What is HCPCS code L0467?

Accepted Answer

HCPCS code L0467 is "Tlso r fram soft pre ots". Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf

Question 2

What category is L0467 in?

Accepted Answer

L0467 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L0467?

Accepted Answer

Use L0467 when billing for tlso r fram soft pre ots. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is L0467 covered by Medicare?

Accepted Answer

Coverage for L0467 (Tlso r fram soft pre ots) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for L0467?

Accepted Answer

Documentation for L0467 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).