Question 1

What is HCPCS code L2627?

Accepted Answer

HCPCS code L2627 is "Plastic mold recipro hip & c". Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables

Question 2

What category is L2627 in?

Accepted Answer

L2627 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L2627?

Accepted Answer

Use L2627 when billing for plastic mold recipro hip & 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 L2627 covered by Medicare?

Accepted Answer

Coverage for L2627 (Plastic mold recipro hip & 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 L2627?

Accepted Answer

Documentation for L2627 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).