Question 1

What is HCPCS code L2800?

Accepted Answer

HCPCS code L2800 is "Knee cap medial or lateral p". Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only

Question 2

What category is L2800 in?

Accepted Answer

L2800 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L2800?

Accepted Answer

Use L2800 when billing for knee cap medial or lateral p. 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 L2800 covered by Medicare?

Accepted Answer

Coverage for L2800 (Knee cap medial or lateral p) 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 L2800?

Accepted Answer

Documentation for L2800 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).