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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 was recently contacted by a patient whose brace was destroyed during a hurricane. Would Medicare pay for another brace? A: Yes, Medicare will pay for another brace. You need to file a hardcopy claim with documentation stating the nature of the disaster and the damage the brace suffered. At the top of the claim form, indicate in large bold letters "Disaster Claim" and the nature of the disaster, e.g., "hurricane claim." Q: I am the billing representative in our office and cannot seem to figure out why I keep getting CO-50 denials from Medicare for L-5980. I bill this with the other component, L-5540, for which I receive payment. A: The L-5980, Flex-Foot ® system, is not meant to be used with the L-5540 code, which is for a below-knee prosthesis with a SACH foot interface. The coverage is according to the functional levels: L-5980 is level 3 and L-5540 is level 1. Q: I read your column last month and am curious what the codes are for billing the labor on a repair for a prosthetic or orthotic item. Can you give those? A: The code for labor on an orthotic repair is L-4205. The code for labor on a prosthetic device is L-7520. These are for 15-minute intervals. Again, this is the time involved for a repair or adjustment made at least 90 days after delivery. We invite readers to ask any questions you have regarding billing, collections, or any other information. To send your questions or for more information, contact: lisa@westernmediallc.com Acc-Q-Data provides billing, collections, and practice management software serving the O&P industry nationwide for over a decade. Lisa Lake-Salmon is Executive Vice President of Acc-Q-Data Inc.

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Related posts:

NYSAAOP Changes Venue

DMERC Conducts Diabetic Shoes/Inserts Probe Review

DMERC Conducts Diabetic Shoes/Inserts Probe Review

RECENT NEWS

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O&P JOBS

Pediatric Orthotic & Prosthetic Clinician Department of Orthopaedic Surgery – UCSF

CERTIFIED ORTHOTIC FITTER

Certified Orthotist & Orthotic Technician

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