Question 1

What is HCPCS code L0623?

Accepted Answer

HCPCS code L0623 is "Sio rig pnl pelv/sac pre ots". Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf

Question 2

What category is L0623 in?

Accepted Answer

L0623 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L0623?

Accepted Answer

Use L0623 when billing for sio rig pnl pelv/sac 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 L0623 covered by Medicare?

Accepted Answer

Coverage for L0623 (Sio rig pnl pelv/sac 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 L0623?

Accepted Answer

Documentation for L0623 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).