<img style="float: right;" src="https://opedge.com/Content/OldArticles/images/2005-07_07/salmon.jpg" hspace="4" vspace="4" /> 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 staffwith a better understanding of billing procedures and reimbursement strategies. <b>Q: <i>I recently provided a service to a patient for which I will be using the new code of K-0670 that became effective on April 1, 2005. I have been unable to locate the allowable for the state of Illinois. Can you please direct me to where I may find this information?</i></b> <b>A:</b> According to DMERC Region B, the allowable for Code K-0670 (Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor, any type), is $9,679.24. This information is now listed in the 2005 April Quarterly DMEPOS Fee Schedule Update. <b>Q: </b><b><i>I have been billing codes K-0646 and K-0648, which are replacement codes for the old L-0565, but I have been using the old fee schedule. Has Medicare updated the K-Codes to new prices, or have they remained the same?</i></b> <b>A:</b> When Medicare replaced the Code L-0565 with the new K-Codes, which took effect on January 1, 2005, the fee schedule amounts crossed over as well. You are billing correctly by using the old allowable amount with the new Codes K-0646 and K-0648. <b>Q: <i>I had billed Medicare about a year ago with a claim that was denied for CO- 50 (Not medically necessary). This claim had fallen through the cracks in my office, and when I came across the claim again, I tried to re-submit the claim with the corrected information to Medicare. The claim was denied again for duplicate claim. Is there additional action I can take to get this claim paid by Medicare?</i></b> <b>A:</b> Unfortunately there is nothing that you can do. For any claim that receives a denial code of CO-50, you only have 120 days to submit the claim into review from the original denial date. Since your claim was re-submitted later than the 120 days, Medicare denied it as a duplicate and will not process your claim for payment. <i>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: <a href="mailto:lisa@westernmediallc.com">lisa@westernmediallc.com</a></i> <i>Acc-Q-Data provides billing, collections, and practice management software, serving the O&P industry nationwide for over a decade.</i> <i>Lisa Lake-Salmon is Executive Vice President, Acc-Q-Data, Inc.</i>
<img style="float: right;" src="https://opedge.com/Content/OldArticles/images/2005-07_07/salmon.jpg" hspace="4" vspace="4" /> 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 staffwith a better understanding of billing procedures and reimbursement strategies. <b>Q: <i>I recently provided a service to a patient for which I will be using the new code of K-0670 that became effective on April 1, 2005. I have been unable to locate the allowable for the state of Illinois. Can you please direct me to where I may find this information?</i></b> <b>A:</b> According to DMERC Region B, the allowable for Code K-0670 (Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor, any type), is $9,679.24. This information is now listed in the 2005 April Quarterly DMEPOS Fee Schedule Update. <b>Q: </b><b><i>I have been billing codes K-0646 and K-0648, which are replacement codes for the old L-0565, but I have been using the old fee schedule. Has Medicare updated the K-Codes to new prices, or have they remained the same?</i></b> <b>A:</b> When Medicare replaced the Code L-0565 with the new K-Codes, which took effect on January 1, 2005, the fee schedule amounts crossed over as well. You are billing correctly by using the old allowable amount with the new Codes K-0646 and K-0648. <b>Q: <i>I had billed Medicare about a year ago with a claim that was denied for CO- 50 (Not medically necessary). This claim had fallen through the cracks in my office, and when I came across the claim again, I tried to re-submit the claim with the corrected information to Medicare. The claim was denied again for duplicate claim. Is there additional action I can take to get this claim paid by Medicare?</i></b> <b>A:</b> Unfortunately there is nothing that you can do. For any claim that receives a denial code of CO-50, you only have 120 days to submit the claim into review from the original denial date. Since your claim was re-submitted later than the 120 days, Medicare denied it as a duplicate and will not process your claim for payment. <i>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: <a href="mailto:lisa@westernmediallc.com">lisa@westernmediallc.com</a></i> <i>Acc-Q-Data provides billing, collections, and practice management software, serving the O&P industry nationwide for over a decade.</i> <i>Lisa Lake-Salmon is Executive Vice President, Acc-Q-Data, Inc.</i>