Question 1

What is HCPCS code L1971?

Accepted Answer

HCPCS code L1971 is "Afo w/ankle joint, prefab". Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment

Question 2

What category is L1971 in?

Accepted Answer

L1971 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L1971?

Accepted Answer

Use L1971 when billing for afo w/ankle joint, prefab. 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 L1971 covered by Medicare?

Accepted Answer

Coverage for L1971 (Afo w/ankle joint, prefab) 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 L1971?

Accepted Answer

Documentation for L1971 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).