Question 1

What is HCPCS code L6695?

Accepted Answer

HCPCS code L6695 is "Elbow socket ins use w/o lck". Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism

Question 2

What category is L6695 in?

Accepted Answer

L6695 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L6695?

Accepted Answer

Use L6695 when billing for elbow socket ins use w/o lck. 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 L6695 covered by Medicare?

Accepted Answer

Coverage for L6695 (Elbow socket ins use w/o lck) 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 L6695?

Accepted Answer

Documentation for L6695 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).