Question 1

What is HCPCS code L5210?

Accepted Answer

HCPCS code L5210 is "No knee/ankle joints w/ ft b". Above knee, short prosthesis, no knee joint ('stubbies'), with foot blocks, no ankle joints, each

Question 2

What category is L5210 in?

Accepted Answer

L5210 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L5210?

Accepted Answer

Use L5210 when billing for no knee/ankle joints w/ ft b. 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 L5210 covered by Medicare?

Accepted Answer

Coverage for L5210 (No knee/ankle joints w/ ft b) 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 L5210?

Accepted Answer

Documentation for L5210 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).