Got FAQs?

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By Lisa Lake-Salmon

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 informative column will help providers and their staff with a better understanding of billing procedures and reimbursement strategies.

Q: I receive my Medicare payments and EOBs electronically. Is it necessary to inform Medicare if I move to a new physical address, since I do not receive anything by mail from them?

A: According to the Medicare Supplier Standard #2, suppliers are required to inform the National Supplier Clearinghouse (NSC) of any location change within 30 days. I suggest you notify the NSC as soon as possible since failure to do so could result in the termination of your supplier number.

Q: I am an O&P provider with multiple locations throughout West Virginia. I applied for an NPI number for my main office only, and I am not sure if I need to apply for one for each of my locations?

A: If you are a sole proprietor of your practice, it is not necessary to obtain an NPI number for each location. According to CMS, if a Medicare supplier is a sole proprietor, he/she is eligible for only one NPI number regardless of the number of locations. If you are not a sole proprietor of your practice, then it is necessary to obtain an NPI number for each location.

Q: Can you tell me what the allowable amount is for L-3672 and L-3673 for the state of Oregon? I looked for these codes on the Medicare fee schedule for 2006 and can not find the allowable amount anywhere. I want to make sure we are billing the appropriate amount.

A: HCPCS code L-3672 and L-3673 did not appear on the Medicare fee schedule until July 2006. The allowable amount for the state of Oregon is L-3672 ($801.31) and L-3673 ($873.35). The updated third-quarter fee schedule is now available on the DMERC Region D website.

We invite readers to ask questions regarding billing, collections, or related subjects. For more information, contact lisa@opedge.com Acc-Q-Data provides billing, collections, and practice management software and has served the O&P industry nationwide for more than a decade.

Lisa Lake-Salmon is Executive Vice President, Acc-Q-Data Inc.