Question 1

What is HCPCS code L5827?

Accepted Answer

HCPCS code L5827 is "Endo knee shin single axis". Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping

Question 2

What category is L5827 in?

Accepted Answer

L5827 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L5827?

Accepted Answer

Use L5827 when billing for endo knee shin single axis. 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 L5827 covered by Medicare?

Accepted Answer

Coverage for L5827 (Endo knee shin single axis) 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 L5827?

Accepted Answer

Documentation for L5827 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).