Question 1

What is HCPCS code L5926?

Accepted Answer

HCPCS code L5926 is "Endoskel posit rotat unit". Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type

Question 2

What category is L5926 in?

Accepted Answer

L5926 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L5926?

Accepted Answer

Use L5926 when billing for endoskel posit rotat unit. 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 L5926 covered by Medicare?

Accepted Answer

Coverage for L5926 (Endoskel posit rotat unit) 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 L5926?

Accepted Answer

Documentation for L5926 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).