Question 1

What is HCPCS code L1630?

Accepted Answer

HCPCS code L1630 is "Abduct control hip semi-flex". Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated

Question 2

What category is L1630 in?

Accepted Answer

L1630 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L1630?

Accepted Answer

Use L1630 when billing for abduct control hip semi-flex. 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 L1630 covered by Medicare?

Accepted Answer

Coverage for L1630 (Abduct control hip semi-flex) 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 L1630?

Accepted Answer

Documentation for L1630 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).