Question 1

What is HCPCS code L1690?

Accepted Answer

HCPCS code L1690 is "Combination bilateral ho". Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment

Question 2

What category is L1690 in?

Accepted Answer

L1690 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L1690?

Accepted Answer

Use L1690 when billing for combination bilateral ho. 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 L1690 covered by Medicare?

Accepted Answer

Coverage for L1690 (Combination bilateral ho) 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 L1690?

Accepted Answer

Documentation for L1690 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).