Question 1

What is HCPCS code L5420?

Accepted Answer

HCPCS code L5420 is "Postop dsg & 1 cast chg ak/d". Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change 'ak' or knee disarticulation

Question 2

What category is L5420 in?

Accepted Answer

L5420 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L5420?

Accepted Answer

Use L5420 when billing for postop dsg & 1 cast chg ak/d. 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 L5420 covered by Medicare?

Accepted Answer

Coverage for L5420 (Postop dsg & 1 cast chg ak/d) 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 L5420?

Accepted Answer

Documentation for L5420 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).