Question 1

What is HCPCS code L1640?

Accepted Answer

HCPCS code L1640 is "Pelv band/spread bar thigh c". Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated

Question 2

What category is L1640 in?

Accepted Answer

L1640 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L1640?

Accepted Answer

Use L1640 when billing for pelv band/spread bar thigh c. 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 L1640 covered by Medicare?

Accepted Answer

Coverage for L1640 (Pelv band/spread bar thigh c) 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 L1640?

Accepted Answer

Documentation for L1640 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).