Billing for O&P devices seems to get more complicated by the day. Count on Got FAQs? to help answer your toughest questions. This month’s column addresses your questions about prior authorization for knee orthoses and any willing provider statutes.
Q: I work for an orthopedic surgeon in Texas. We recently opened an orthotic facility and received our Medicare provider number so we can bill for custom orthotics. We hired a practitioner, and I want to ensure I have all the proper documentation and clear understanding about how to bill these items. I have heard that we may need to start obtaining prior authorization for certain orthotic devices. Does that apply to knee braces? Our physician has been reading your column for over 15 years and is extremely impressed with your knowledge and understanding.