Question 1

What is HCPCS code L8049?

Accepted Answer

HCPCS code L8049 is "Repair maxillofacial prosth". Repair or modification of maxillofacial prosthesis, labor component, 15 minute increments, provided by a non-physician

Question 2

What category is L8049 in?

Accepted Answer

L8049 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L8049?

Accepted Answer

Use L8049 when billing for repair maxillofacial prosth. 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 L8049 covered by Medicare?

Accepted Answer

Coverage for L8049 (Repair maxillofacial prosth) 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 L8049?

Accepted Answer

Documentation for L8049 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).