Question 1

What is HCPCS code L3806?

Accepted Answer

HCPCS code L3806 is "Whfo w/joint(s) custom fab". Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment

Question 2

What category is L3806 in?

Accepted Answer

L3806 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L3806?

Accepted Answer

Use L3806 when billing for whfo w/joint(s) custom fab. 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 L3806 covered by Medicare?

Accepted Answer

Coverage for L3806 (Whfo w/joint(s) custom fab) 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 L3806?

Accepted Answer

Documentation for L3806 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).