Question 1

What is HCPCS code L8659?

Accepted Answer

HCPCS code L8659 is "Interphalangeal joint repl". Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size

Question 2

What category is L8659 in?

Accepted Answer

L8659 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L8659?

Accepted Answer

Use L8659 when billing for interphalangeal joint repl. 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 L8659 covered by Medicare?

Accepted Answer

Coverage for L8659 (Interphalangeal joint repl) 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 L8659?

Accepted Answer

Documentation for L8659 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).