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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 have recently received a denial from Medicare for Code L-5675, and I do not understand why this would be denied when I was always reimbursed for this in the past. A: Effective Jan 1, 2005, Code L-5675 is no longer valid. Try resubmitting your claim using Code L-5685 (Addition to lower extremity, below knee, suspen- sion sleeve, heavy duty). This is the replacement code for L-5675 and L-5674. Q: If I deliver a spinal orthosis to a patient in a hospital or Part A SNF, will Medicare reimburse me for this? A: According to DMERC, this would be covered if the orthosis is medically necessary for a patient after discharge from a hospital or Part A-covered SNF stay; the orthosis is provided to the patient within two days prior to discharge; and the orthosis is not needed for inpatient treatment or rehabilitation, but is left in the room for the patient to take home. Q: I received an email stating that L-5685, L-5856, and L-5857 were new HCPCS codes for lower extremity but cannot fi nd a description for these anywhere. Do you have the descriptions for these codes? A: These codes are effective as of Jan 1, 2005, and are described as follows: L-5685 (addition to lower-extremity prosthesis, below knee, suspension/ sealing sleeve, with or without valve), L-5856 (addition to lower-extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor any type), and L-5857 (the same description as L-5856, except this is a swing phase only.) We invite readers to ask any questions you may 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, Acc-Q-Data Inc.

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PrimeFare To Host Dr. Brennan

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