Question 1

What is HCPCS code L4360?

Accepted Answer

HCPCS code L4360 is "Pneumat walking boot pre cst". Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Question 2

What category is L4360 in?

Accepted Answer

L4360 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L4360?

Accepted Answer

Use L4360 when billing for pneumat walking boot pre cst. 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 L4360 covered by Medicare?

Accepted Answer

Coverage for L4360 (Pneumat walking boot pre cst) 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 L4360?

Accepted Answer

Documentation for L4360 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).