L- Codes are not listed in the Current Procedural Terminology (CPT) book, but they are in the HCPCS Level II book. These L codes contain custom fabricated and pre-fabricated orthoses, and you should choose the appropriate ActiveWrap code to match your model.

If you work in a hospital setting, you do not need a durable medical equipment (DME) supplier number to bill and be reimbursed for L codes for custom fabricated or prefabricated devices provided to Medicare benficiaries under Part B benefits during therapy. Providers who submit claims to fiscal intermediaries do not require a DME supplier number in order to be reimbursed for L codes delivered during therapy for outpatient physical and occupational therpay services. Providers should bill the appropriate L codes on the UB-92 claim form, along with other services during that billing period.

This provision covers hospitals, skilled nursing facilities providing outpatient therapy services under part B, comprehensive outpatient rehab facilities and home health agencies providing services that are not covered under a home health plan of care. PT and OT therapy private practitioneers need a DME supplier number to be reimbursed for L codes. They submit claims to a DME regional carrier.