HCPCS code L1820: Knee Orthosis, Elastic With Condylar Pads and Joints, With or Without Patellar Control, Prefabricated Item Trimmed and Fitted by an Expert

Ensure proper coding and billing of HCPCS code L1820 by obtaining a list of the code's documentation and billing requirements.

Use Code

Frequently asked questions

Use L1820 when the prefabricated knee brace is professionally customized at delivery. Use L1821 when the same model is provided off-the-shelf without professional fitting.

Typically, once per year per knee is allowed for prefabricated orthoses as reasonably useful lifetime; exceeding that may result in denial.

Payer policies vary. While L1820 does not always require prior authorization from Medicare, it's essential to check the specific requirements of the patient's insurance plan before providing the brace to avoid a denial.