May 2006 Issue
The future of your practice depends on knowledgeable billing and collection information. Understanding the full aspect of billing guidelines and procedures will effectively increase your reimbursement. This iformative column will help providers and their staff with a better understanding of billing procedures and reimbursement strategies.
Q: I am a new provider in Region C, and I was wondering if you can advise me of any new or deleted codes for 2006 strictly for ankle foot orthoses?
A: According to the Healthcare Common Procedure Coding System (HCPCS) level II, the added codes for this category are L-2034 (knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle) and L-2387 (addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint). Effective January 1, 2006, procedure code L-2039 has been discontinued.
Q: Do the L-Codes for compression stockings change per region?
A: The changes for the compression stockings that took place January 1, 2006, are for all four DMERC regions.
Q: I have been billing K-0628 and K-0629 every way Medicare has told me.I am still not getting paid. I was told to use RT/LT modifiers. Then I was told to use KX modifiers. At one point I was told not to use modifiers. I then was told not to use these codes at all. What do I have to do to get paid on these codes?
A: If the date of service you are billing for is after January 1, 2006, the codesyou are using may not be valid anymore. As of January 1, K-0628 was replaced with A-5512, and K-0629 was replaced with A-5513 . If your date of service is prior to January 1, 2006, I would need the denial code or reason listed on the Medicare EOB to further assist you in this matter.
We invite readers to ask questions regarding billing, collections, or related subjects.Acc-Q-Data provides billing, collections, and practice management software and has served the O&P industry nationwide for more than a decade. For more information contact firstname.lastname@example.org
Lisa Lake-Salmon is Executive Vice President, Acc-Q-Data Inc.