Question 1

What is HCPCS code L5321?

Accepted Answer

HCPCS code L5321 is "Ak open end sach". Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee

Question 2

What category is L5321 in?

Accepted Answer

L5321 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L5321?

Accepted Answer

Use L5321 when billing for ak open end sach. 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 L5321 covered by Medicare?

Accepted Answer

Coverage for L5321 (Ak open end sach) 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 L5321?

Accepted Answer

Documentation for L5321 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).