Question 1

What is HCPCS code L8604?

Accepted Answer

HCPCS code L8604 is "Dextranomer/hyaluronic acid". Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, urinary tract, 1 ml, includes shipping and necessary supplies

Question 2

What category is L8604 in?

Accepted Answer

L8604 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L8604?

Accepted Answer

Use L8604 when billing for dextranomer/hyaluronic acid. 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 L8604 covered by Medicare?

Accepted Answer

Coverage for L8604 (Dextranomer/hyaluronic acid) 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 L8604?

Accepted Answer

Documentation for L8604 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).