Question 1

What is HCPCS code L5981?

Accepted Answer

HCPCS code L5981 is "Flex-walk sys low ext prosth". All lower extremity prostheses, flex-walk system or equal

Question 2

What category is L5981 in?

Accepted Answer

L5981 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L5981?

Accepted Answer

Use L5981 when billing for flex-walk sys low ext prosth. 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 L5981 covered by Medicare?

Accepted Answer

Coverage for L5981 (Flex-walk sys low ext prosth) 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 L5981?

Accepted Answer

Documentation for L5981 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).