Question 1

What is HCPCS code L6940?

Accepted Answer

HCPCS code L6940 is "Elbow disarticulation switch". Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device

Question 2

What category is L6940 in?

Accepted Answer

L6940 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L6940?

Accepted Answer

Use L6940 when billing for elbow disarticulation switch. 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 L6940 covered by Medicare?

Accepted Answer

Coverage for L6940 (Elbow disarticulation switch) 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 L6940?

Accepted Answer

Documentation for L6940 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).