Question 1

What is HCPCS code L5822?

Accepted Answer

HCPCS code L5822 is "Endo knee-shin pneum swg frc". Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control

Question 2

What category is L5822 in?

Accepted Answer

L5822 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L5822?

Accepted Answer

Use L5822 when billing for endo knee-shin pneum swg frc. 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 L5822 covered by Medicare?

Accepted Answer

Coverage for L5822 (Endo knee-shin pneum swg frc) 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 L5822?

Accepted Answer

Documentation for L5822 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).