Question 1

What is HCPCS code L0174?

Accepted Answer

HCPCS code L0174 is "Cerv sr 2pc thor ext pre ots". Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf

Question 2

What category is L0174 in?

Accepted Answer

L0174 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L0174?

Accepted Answer

Use L0174 when billing for cerv sr 2pc thor ext pre ots. 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 L0174 covered by Medicare?

Accepted Answer

Coverage for L0174 (Cerv sr 2pc thor ext pre ots) 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 L0174?

Accepted Answer

Documentation for L0174 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).