Question 1

What is HCPCS code L6039?

Accepted Answer

HCPCS code L6039 is "Passive custom digit/thumb". Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb

Question 2

What category is L6039 in?

Accepted Answer

L6039 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L6039?

Accepted Answer

Use L6039 when billing for passive custom digit/thumb. 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 L6039 covered by Medicare?

Accepted Answer

Coverage for L6039 (Passive custom digit/thumb) 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 L6039?

Accepted Answer

Documentation for L6039 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).