Question 1

What is HCPCS code L6900?

Accepted Answer

HCPCS code L6900 is "Hand restorat thumb/1 finger". Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining

Question 2

What category is L6900 in?

Accepted Answer

L6900 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L6900?

Accepted Answer

Use L6900 when billing for hand restorat thumb/1 finger. 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 L6900 covered by Medicare?

Accepted Answer

Coverage for L6900 (Hand restorat thumb/1 finger) 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 L6900?

Accepted Answer

Documentation for L6900 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).