Question 1

What is HCPCS code L5220?

Accepted Answer

HCPCS code L5220 is "No knee joint with artic ali". Above knee, short prosthesis, no knee joint ('stubbies'), with articulated ankle/foot, dynamically aligned, each

Question 2

What category is L5220 in?

Accepted Answer

L5220 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L5220?

Accepted Answer

Use L5220 when billing for no knee joint with artic ali. 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 L5220 covered by Medicare?

Accepted Answer

Coverage for L5220 (No knee joint with artic ali) 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 L5220?

Accepted Answer

Documentation for L5220 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).