Question 1

What is HCPCS code L6696?

Accepted Answer

HCPCS code L6696 is "Cus elbo skt in for con/atyp". Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)

Question 2

What category is L6696 in?

Accepted Answer

L6696 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L6696?

Accepted Answer

Use L6696 when billing for cus elbo skt in for con/atyp. 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 L6696 covered by Medicare?

Accepted Answer

Coverage for L6696 (Cus elbo skt in for con/atyp) 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 L6696?

Accepted Answer

Documentation for L6696 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).