Question 1

What is HCPCS code L1320?

Accepted Answer

HCPCS code L1320 is "Pectus carinatum ortho cust". Thoracic, pectus carinatum orthosis, sternal compression, rigid circumferential frame with anterior and posterior rigid pads, custom fabricated

Question 2

What category is L1320 in?

Accepted Answer

L1320 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L1320?

Accepted Answer

Use L1320 when billing for pectus carinatum ortho cust. 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 L1320 covered by Medicare?

Accepted Answer

Coverage for L1320 (Pectus carinatum ortho cust) 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 L1320?

Accepted Answer

Documentation for L1320 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).