<img style="float: right;" src="https://opedge.com/Content/OldArticles/images/2004-05_07/Lake-Salmon-Lisa[1].jpg" hspace="4" vspace="4" /> The future of your practice depends on knowledgeable billing and collection information. Understanding the full aspect of billing guidlines 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. <b>Q: Is a walking boot covered by Medicare? If so, when would it be covered and what code would I use to bill?</b> <b>A:</b> L-4360 and L-4386 are ankle-foot orthoses that are referred to as prefabricated walking boots. If the walking boot is used to provide immobilization as treatment for an orthopedic condition or following orthopedic surgery, it would be eligible for coverage under the brace benefit. When walking boots are used to relieve pressure, or are used for patients with foot ulcers, they are noncovered and you must add a GY modifier. <b>Q: I am a new provider of diabetic shoes and have heard that the codes for inserts are no longer A-Codes. Is this true? If so, do you know the new codes?</b> <b>A:</b>Effective for dates of service on or after April 1, 2004, A-5509 will be changed to K-0628, and A-5511 will be changed to K-0629. <b>Q: As an O&P provider, I know I need a business associate agreement, but I am not sure whom I should have one with.</b> <b>A:</b> A business associate is an organization or person, other than a member of a covered entity's workforce, who receives electronic protected health information (PHI) to provide services to, or on behalf of, a covered entity. This would include: software vendors, billing services, accountants that view patient information, legal services that assist in patient cases, and management firms that review patient information within the organization. The common thread is that these organizations are not employees of your company, but they assist in managing patient information in one form or another. <i>We invite readers to ask any questions you have regarding billing, collections, or any other related information. To send your questions or for more information, contact: </i><a href="mailto:lisa@westernmediallc.com"><i>lisa@westernmediallc.com</i></a><i>.</i> <i>Acc-Q-Data provides billing, collections, and practice management software and has been serving the O&P industry nationwide for over a decade.</i> <i>Lisa Lake-Salmon is Executive VP of Acc-Q Data, Inc.</i>
<img style="float: right;" src="https://opedge.com/Content/OldArticles/images/2004-05_07/Lake-Salmon-Lisa[1].jpg" hspace="4" vspace="4" /> The future of your practice depends on knowledgeable billing and collection information. Understanding the full aspect of billing guidlines 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. <b>Q: Is a walking boot covered by Medicare? If so, when would it be covered and what code would I use to bill?</b> <b>A:</b> L-4360 and L-4386 are ankle-foot orthoses that are referred to as prefabricated walking boots. If the walking boot is used to provide immobilization as treatment for an orthopedic condition or following orthopedic surgery, it would be eligible for coverage under the brace benefit. When walking boots are used to relieve pressure, or are used for patients with foot ulcers, they are noncovered and you must add a GY modifier. <b>Q: I am a new provider of diabetic shoes and have heard that the codes for inserts are no longer A-Codes. Is this true? If so, do you know the new codes?</b> <b>A:</b>Effective for dates of service on or after April 1, 2004, A-5509 will be changed to K-0628, and A-5511 will be changed to K-0629. <b>Q: As an O&P provider, I know I need a business associate agreement, but I am not sure whom I should have one with.</b> <b>A:</b> A business associate is an organization or person, other than a member of a covered entity's workforce, who receives electronic protected health information (PHI) to provide services to, or on behalf of, a covered entity. This would include: software vendors, billing services, accountants that view patient information, legal services that assist in patient cases, and management firms that review patient information within the organization. The common thread is that these organizations are not employees of your company, but they assist in managing patient information in one form or another. <i>We invite readers to ask any questions you have regarding billing, collections, or any other related information. To send your questions or for more information, contact: </i><a href="mailto:lisa@westernmediallc.com"><i>lisa@westernmediallc.com</i></a><i>.</i> <i>Acc-Q-Data provides billing, collections, and practice management software and has been serving the O&P industry nationwide for over a decade.</i> <i>Lisa Lake-Salmon is Executive VP of Acc-Q Data, Inc.</i>