Question 1

What is HCPCS code L6310?

Accepted Answer

HCPCS code L6310 is "Shoulder passive restor comp". Shoulder disarticulation, passive restoration (complete prosthesis)

Question 2

What category is L6310 in?

Accepted Answer

L6310 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L6310?

Accepted Answer

Use L6310 when billing for shoulder passive restor comp. 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 L6310 covered by Medicare?

Accepted Answer

Coverage for L6310 (Shoulder passive restor comp) 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 L6310?

Accepted Answer

Documentation for L6310 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).