<img style="float: right;" src="https://opedge.com/Content/OldArticles/images/2007-01_09/Lake-Salmon,-Lisa-(sm).jpg" hspace="4" vspace="4" /> <b><i>Competitive bidding, NPI numbers, DX Code updates, Medicare contractor reform, etc. Keeping up with the new Medicare 2007 rules and regulation changes can become very overwhelming. Count on "GOT FAQS" to keep you informed as you prepare for O&P in 2007 and beyond.</i></b> <b><i>Q:</i> Can you tell me what the Medicare Part B deductible will be for 2007? Also if a patient cannot afford the 20 percent Medicare co-pay, is it okay for me just to write these charges off?</b> <b>A:</b> The Medicare Part B deductible for 2007 has been increased to $131 per year. The law requires the provider to make an effort to collect the 20 percent co-insurance payment. The supplier must keep evidence on file of the attempt to collect this from either the patient or the secondary insurance. The supplier has an option of waiving the co-insurance in case of hardship; however, a supplier cannot routinely waive the 20 percent co-insurance payment for every patient. <b><i>Q:</i> I have a patient who requires prefabricated thermoformable liners. Can you let me know what codes I would use to bill these items? The date of service for this claim is November 2006.</b> <b>A:</b> The correct coding for prefabricated thermoformable liners is L-5673 (addition to lower extremity, below knee/above knee, 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, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism). <b><i>Q:</i> I am a region D provider who was receiving payments from Medicare electronically. Recently I stopped receiving these funds into my bank account and started receiving checks again. What do I need to do in order to receive my funds directly into my account again? Do you know why Medicare would have stopped?</b> <b>A:</b> Noridian Administrative Services sent out notifications to all providers to fill out a new CMS 588 form (Electronic Funds Transfer) when they took over on 9/30/2006 for DMERC D. If they did not receive the form back from you by December 1, 2006, they would have switched you back to receiving paper checks. You need to fill out a new EFT form and send the original agreement to Noridian Administrative Services, PO Box 6728, Fargo, ND, 58108-6728. If you have any questions regarding the form, you may send an e-mail to <a href="mailto:DME@noridian.com">DME@noridian.com</a> <i>We invite readers to ask questions regarding billing, collections, or related subjects. For more information, contact <a href="mailto:lisa@opedge.com">lisa@opedge.com</a> </i><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> <i>Lisa Lake-Salmon is Executive Vice President, Acc-Q-Data Inc.</i>
<img style="float: right;" src="https://opedge.com/Content/OldArticles/images/2007-01_09/Lake-Salmon,-Lisa-(sm).jpg" hspace="4" vspace="4" /> <b><i>Competitive bidding, NPI numbers, DX Code updates, Medicare contractor reform, etc. Keeping up with the new Medicare 2007 rules and regulation changes can become very overwhelming. Count on "GOT FAQS" to keep you informed as you prepare for O&P in 2007 and beyond.</i></b> <b><i>Q:</i> Can you tell me what the Medicare Part B deductible will be for 2007? Also if a patient cannot afford the 20 percent Medicare co-pay, is it okay for me just to write these charges off?</b> <b>A:</b> The Medicare Part B deductible for 2007 has been increased to $131 per year. The law requires the provider to make an effort to collect the 20 percent co-insurance payment. The supplier must keep evidence on file of the attempt to collect this from either the patient or the secondary insurance. The supplier has an option of waiving the co-insurance in case of hardship; however, a supplier cannot routinely waive the 20 percent co-insurance payment for every patient. <b><i>Q:</i> I have a patient who requires prefabricated thermoformable liners. Can you let me know what codes I would use to bill these items? The date of service for this claim is November 2006.</b> <b>A:</b> The correct coding for prefabricated thermoformable liners is L-5673 (addition to lower extremity, below knee/above knee, 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, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism). <b><i>Q:</i> I am a region D provider who was receiving payments from Medicare electronically. Recently I stopped receiving these funds into my bank account and started receiving checks again. What do I need to do in order to receive my funds directly into my account again? Do you know why Medicare would have stopped?</b> <b>A:</b> Noridian Administrative Services sent out notifications to all providers to fill out a new CMS 588 form (Electronic Funds Transfer) when they took over on 9/30/2006 for DMERC D. If they did not receive the form back from you by December 1, 2006, they would have switched you back to receiving paper checks. You need to fill out a new EFT form and send the original agreement to Noridian Administrative Services, PO Box 6728, Fargo, ND, 58108-6728. If you have any questions regarding the form, you may send an e-mail to <a href="mailto:DME@noridian.com">DME@noridian.com</a> <i>We invite readers to ask questions regarding billing, collections, or related subjects. For more information, contact <a href="mailto:lisa@opedge.com">lisa@opedge.com</a> </i><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> <i>Lisa Lake-Salmon is Executive Vice President, Acc-Q-Data Inc.</i>