Question 1

What is HCPCS code L5632?

Accepted Answer

HCPCS code L5632 is "Symes type ptb brim design s". Addition to lower extremity, symes type, 'ptb' brim design socket

Question 2

What category is L5632 in?

Accepted Answer

L5632 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L5632?

Accepted Answer

Use L5632 when billing for symes type ptb brim design s. 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 L5632 covered by Medicare?

Accepted Answer

Coverage for L5632 (Symes type ptb brim design s) 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 L5632?

Accepted Answer

Documentation for L5632 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).