Question 1

What is HCPCS code L5648?

Accepted Answer

HCPCS code L5648 is "Above knee cushion socket". Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket

Question 2

What category is L5648 in?

Accepted Answer

L5648 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L5648?

Accepted Answer

Use L5648 when billing for above knee cushion socket. 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 L5648 covered by Medicare?

Accepted Answer

Coverage for L5648 (Above knee cushion socket) 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 L5648?

Accepted Answer

Documentation for L5648 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).