Question 1

What is HCPCS code L0460?

Accepted Answer

HCPCS code L0460 is "Tlso 2 shl symphys-stern cst". Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Question 2

What category is L0460 in?

Accepted Answer

L0460 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L0460?

Accepted Answer

Use L0460 when billing for tlso 2 shl symphys-stern cst. 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 L0460 covered by Medicare?

Accepted Answer

Coverage for L0460 (Tlso 2 shl symphys-stern cst) 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 L0460?

Accepted Answer

Documentation for L0460 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).