Question 1

What is HCPCS code L5781?

Accepted Answer

HCPCS code L5781 is "Lower limb pros vacuum pump". Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system

Question 2

What category is L5781 in?

Accepted Answer

L5781 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L5781?

Accepted Answer

Use L5781 when billing for lower limb pros vacuum pump. 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 L5781 covered by Medicare?

Accepted Answer

Coverage for L5781 (Lower limb pros vacuum pump) 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 L5781?

Accepted Answer

Documentation for L5781 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).