Question 1

What is HCPCS code L1980?

Accepted Answer

HCPCS code L1980 is "Afo sing solid stirrup calf". Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar 'bk' orthosis), custom fabricated

Question 2

What category is L1980 in?

Accepted Answer

L1980 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L1980?

Accepted Answer

Use L1980 when billing for afo sing solid stirrup calf. 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 L1980 covered by Medicare?

Accepted Answer

Coverage for L1980 (Afo sing solid stirrup calf) 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 L1980?

Accepted Answer

Documentation for L1980 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).