Question 1

What is HCPCS code L5962?

Accepted Answer

HCPCS code L5962 is "Below knee flex cover system". Addition, endoskeletal system, below knee, flexible protective outer surface covering system

Question 2

What category is L5962 in?

Accepted Answer

L5962 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L5962?

Accepted Answer

Use L5962 when billing for below knee flex cover system. 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 L5962 covered by Medicare?

Accepted Answer

Coverage for L5962 (Below knee flex cover system) 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 L5962?

Accepted Answer

Documentation for L5962 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).