Billing and Collections Q&A

The O&P profession becomes increasingly complex every year, and billing for O&P is just as complex. Count on 'Got FAQs?' to help make your billing processes a little less complicated. This month's column tackles your questions about documentation for diabetic shoes, accreditation, salvage claims, and billable rates to Medicare . Q: I am a physician who is going to begin providing diabetic shoes to my patients. Where can I find information on the documentation requirements? I am not that familiar with billing for such items. A: There are several links that you can use to better understand documentation requirements for diabetic shoes. You can review the complete Local Coverage Determination (LCD) and Policy Article (PA) at cignagovernmentservices.com/jc/coverage/lcdinfo.html . It may also be viewed at www.cms.hhs.gov Q: I am a pedorthist in the state of New Jersey, and I have not started the accreditation process. I don't know where to begin and feel very overwhelmed. Is there a company or organization that you can recommend to help get me through this process? A: The Centers for Medicare & Medicaid Services (CMS) has published a list of accreditation requirements and "deemed" accreditation organizations that can help you through this process. Visit www.cms.hhs.gov/medicareprovidersupenroll/~ . These documents and resources should help you begin the accreditation process. Q: We made a custom brace for a patient. When we called to schedule an appointment for the patient to pick up the brace, we were informed the individual had died. I do not want to come across as insensitive, but the brace was expensive to make. Is there any way that Medicare would still pay for such a thing? A: Medicare allows you to bill for a salvage claim. The allowed amount is based on the services furnished and materials used up to the date the supplier learned of the beneficiary's death. Medicare determines which services and amounts are allowable in each situation. It will take into account any salvage value of the device to the supplier. To view Medicare's policy on this, visit www.cms.hhs.gov/manuals/downloads/bp102c15.pdf Q: A colleague of mine told me that I should bill Medicare for L-7520 at $75.00 per hour. Do you agree? Do you know what Medicare pays for labor (L-7520)? I am located in the state of Ohio. Also, should I bill per hour? Someone else told me to bill for every 15 minutes. A: I hope that you are sitting down for this one: As of 2009, Medicare has increased its allowable amount for L-7520 per 15 minutes. Yes, I said that Medicare actually increased its rates! The range for the allowable amount, depending on your state, ranges from $27.14 to $42.27 per 15 minutes. If you would like to know the exact amount allowed for your state, visit www.cms.hhs.gov/transmittals/downloads/r421otn.pdf . Lisa Lake-Salmon is the executive vice president of Acc-Q-Data, which provides billing, collections, and practice management software. She has been serving the O&P profession for more than a decade. We invite readers to write in and ask any questions they may have regarding billing, collections, or related subjects. While every attempt has been made to ensure accuracy, The O&P EDGE is not responsible for errors. For more information, contact linkEmail('lisa','opedge.com'); or visit www.acc-q-data.com

Billing and Collections Q&A

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Billing and Collections Q&A

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CMS to Hold PECOS Forum

University of Hartford to Offer MSPO

University of Hartford to Offer MSPO

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Certified Prosthetist Orthotist

CPO, CP, or Resident

Orthotic and Prosthetic Clinics of America—Jacksonville, FL

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