Question 1

What is HCPCS code L6205?

Accepted Answer

HCPCS code L6205 is "Elbow molded w/ expand inter". Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm

Question 2

What category is L6205 in?

Accepted Answer

L6205 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L6205?

Accepted Answer

Use L6205 when billing for elbow molded w/ expand inter. 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 L6205 covered by Medicare?

Accepted Answer

Coverage for L6205 (Elbow molded w/ expand inter) 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 L6205?

Accepted Answer

Documentation for L6205 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).