Question 1

What is HCPCS code L1920?

Accepted Answer

HCPCS code L1920 is "Afo sing upright w/ adjust s". Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated

Question 2

What category is L1920 in?

Accepted Answer

L1920 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L1920?

Accepted Answer

Use L1920 when billing for afo sing upright w/ adjust s. 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 L1920 covered by Medicare?

Accepted Answer

Coverage for L1920 (Afo sing upright w/ adjust s) 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 L1920?

Accepted Answer

Documentation for L1920 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).