Question 1

What is HCPCS code L3999?

Accepted Answer

HCPCS code L3999 is "Upper limb orthosis nos". Upper limb orthosis, not otherwise specified

Question 2

What category is L3999 in?

Accepted Answer

L3999 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L3999?

Accepted Answer

Use L3999 when billing for upper limb orthosis nos. 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 L3999 covered by Medicare?

Accepted Answer

Coverage for L3999 (Upper limb orthosis nos) 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 L3999?

Accepted Answer

Documentation for L3999 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).