<img style="float: right;" src="https://opedge.com/Content/OldArticles/images/2006-02_09/gf.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 staff with a better under- standing of billing procedures and reimbursement strategies. <b>Q: I am an O&P provider located in the Region A area of Medicare. I recently heard about a change that will take effect on April 1 that Medicare will no longer allow submission of claims with the doctor's UPIN number being OTH000. This is a generic UPIN number that we have used when we are unable to obtain the correct doctor's UPIN number. Is this information true or just a rumor?</b> <b>A:</b> Yes, the information is correct. As of April 1, 2006, the DMERCs will be returning claims as unprocessable if the doctor's UPIN number is defaulted as the generic OTH000. Claims with dates of service of April 1, 2006, and forward must contain the correct doctor's UPIN number in order for the claim to be processed and paid. <b>Q: I am a provider located in South Carolina and have a patient who requires prefabricated thermoformable liners. Can you let me know what codes I would use to bill these items?</b> <b>A:</b> The correct coding for prefabricated thermoformable liners is L-5673 (addition to lower extremity, bk/ak, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism); or L-5679 (addition to lower extremity, bk/ak, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism). <b>Q: I have billed Medicare in the past and have been paid for K-0670, and now have recently received a denial (CO-16) for the same code.</b> <b>A:</b> Effective January 1, 2006, K-0670 is no longer a valid code. If your date of service is after January 1, 2006, then you should bill with code L-5858 instead. <i>We invite readers to ask questions you have regarding billing, collections, or any other information. To send your questions or for more information, contact:</i><a href="mailto:lisa@opedge.com"><i>lisa@opedge.com</i></a> <i>Acc-Q-Data provides billing, collections, and practice management software and has served the O&P industry nationwide for more than a decade.</i>
<img style="float: right;" src="https://opedge.com/Content/OldArticles/images/2006-02_09/gf.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 staff with a better under- standing of billing procedures and reimbursement strategies. <b>Q: I am an O&P provider located in the Region A area of Medicare. I recently heard about a change that will take effect on April 1 that Medicare will no longer allow submission of claims with the doctor's UPIN number being OTH000. This is a generic UPIN number that we have used when we are unable to obtain the correct doctor's UPIN number. Is this information true or just a rumor?</b> <b>A:</b> Yes, the information is correct. As of April 1, 2006, the DMERCs will be returning claims as unprocessable if the doctor's UPIN number is defaulted as the generic OTH000. Claims with dates of service of April 1, 2006, and forward must contain the correct doctor's UPIN number in order for the claim to be processed and paid. <b>Q: I am a provider located in South Carolina and have a patient who requires prefabricated thermoformable liners. Can you let me know what codes I would use to bill these items?</b> <b>A:</b> The correct coding for prefabricated thermoformable liners is L-5673 (addition to lower extremity, bk/ak, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism); or L-5679 (addition to lower extremity, bk/ak, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism). <b>Q: I have billed Medicare in the past and have been paid for K-0670, and now have recently received a denial (CO-16) for the same code.</b> <b>A:</b> Effective January 1, 2006, K-0670 is no longer a valid code. If your date of service is after January 1, 2006, then you should bill with code L-5858 instead. <i>We invite readers to ask questions you have regarding billing, collections, or any other information. To send your questions or for more information, contact:</i><a href="mailto:lisa@opedge.com"><i>lisa@opedge.com</i></a> <i>Acc-Q-Data provides billing, collections, and practice management software and has served the O&P industry nationwide for more than a decade.</i>