Question 1

What is HCPCS code L5925?

Accepted Answer

HCPCS code L5925 is "Above knee manual lock". Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock

Question 2

What category is L5925 in?

Accepted Answer

L5925 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L5925?

Accepted Answer

Use L5925 when billing for above knee manual lock. 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 L5925 covered by Medicare?

Accepted Answer

Coverage for L5925 (Above knee manual lock) 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 L5925?

Accepted Answer

Documentation for L5925 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).