Question 1

What is HCPCS code L5780?

Accepted Answer

HCPCS code L5780 is "Knee-shin pneum/hydra pneum". Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control

Question 2

What category is L5780 in?

Accepted Answer

L5780 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L5780?

Accepted Answer

Use L5780 when billing for knee-shin pneum/hydra pneum. 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 L5780 covered by Medicare?

Accepted Answer

Coverage for L5780 (Knee-shin pneum/hydra pneum) 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 L5780?

Accepted Answer

Documentation for L5780 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).