Question 1

What is HCPCS code L6920?

Accepted Answer

HCPCS code L6920 is "Wrist disarticul switch ctrl". Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device

Question 2

What category is L6920 in?

Accepted Answer

L6920 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L6920?

Accepted Answer

Use L6920 when billing for wrist disarticul switch ctrl. 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 L6920 covered by Medicare?

Accepted Answer

Coverage for L6920 (Wrist disarticul switch ctrl) 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 L6920?

Accepted Answer

Documentation for L6920 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).