Question 1

What is HCPCS code L6100?

Accepted Answer

HCPCS code L6100 is "Elb mold sock flex hinge pad". Below elbow, molded socket, flexible elbow hinge, triceps pad

Question 2

What category is L6100 in?

Accepted Answer

L6100 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L6100?

Accepted Answer

Use L6100 when billing for elb mold sock flex hinge pad. 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 L6100 covered by Medicare?

Accepted Answer

Coverage for L6100 (Elb mold sock flex hinge pad) 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 L6100?

Accepted Answer

Documentation for L6100 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).