Question 1

What is HCPCS code L6955?

Accepted Answer

HCPCS code L6955 is "Above elbow myoelectronic ct". Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device

Question 2

What category is L6955 in?

Accepted Answer

L6955 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L6955?

Accepted Answer

Use L6955 when billing for above elbow myoelectronic ct. 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 L6955 covered by Medicare?

Accepted Answer

Coverage for L6955 (Above elbow myoelectronic ct) 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 L6955?

Accepted Answer

Documentation for L6955 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).