Question 1

What is HCPCS code L5200?

Accepted Answer

HCPCS code L5200 is "Kne sing axis fric shin sach". Above knee, molded socket, single axis constant friction knee, shin, sach foot

Question 2

What category is L5200 in?

Accepted Answer

L5200 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L5200?

Accepted Answer

Use L5200 when billing for kne sing axis fric shin sach. 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 L5200 covered by Medicare?

Accepted Answer

Coverage for L5200 (Kne sing axis fric shin sach) 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 L5200?

Accepted Answer

Documentation for L5200 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).