Healthcare Common Procedure Coding System (HCPCS) codes are assigned to every task and service a medical practitioner performs and are used to ensure uniformity.
HCPCS Level I: Current Procedural Technology (CPT) five digit numeric coding system developed by the American Medical Association (AMA). For therapy providers these codes begin with 97XXX and are referred to as the 97000 codes that describe each billable service performed. One exception is 99070: supplies and materials. This code is sometimes reimbursed by private insurers and is an "open code" meaning no specific value has been assigned to it.
HCPCS Level II: These codes begin with the letters A-V and represent supplies or equipment. In general, codes beginning with A include dressings and scar sheets and codes beginning with L include orthoses and prosthetics. A DMEPOS supplier number is required to bill Medicare for these codes and not all of the supply codes are reimbursed by Medicare. Private insurers usually do not require a Medicare supplier number to reimburse for supplies. All private plans vary in their coverage of these codes so it is recommended that the patient check with their carrier in advance to determine if a particular code is covered.
The current list of L codes can be found on the ASHT website. The description following the code indicates the joints covered or influenced by the orthosis (S=Shoulder, E=Elbow, W=Wrist, H=Hand, and F=Finger) followed by the letter O for Orthosis. They are also described as without joints (static) or with nontorsion joints, elastic bands or turnbuckles (dynamic) and as prefabricated (P/F), off the shelf (OTS) or custom fabricated (C/F).