Tuesday, June 25, 2024

Problems with parts codes

Elizabeth Park

Hello List,

Have any of you had problems with insurance companies (especially Medicare Advantage plans) not paying on parts codes: L4210 & L7510? They are denying or paying way below MSRP. When denied, the reason they give is always because Medicare doesn’t have an associated fee schedule.

They are saying that the only recourse is to appeal, which never turns out in our favor. Have any of you experienced something similar and how have you handled it?

Any information is greatly appreciated!

~ Elizabeth

Elizabeth A.M. Park, Operations Manager
Sound Limbs Orthotics & Prosthetics

www.soundlimbs.com

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