Re: Coding question

William Schumann

Thank you Pat, for the correction to using the L2330, as it belongs in the ankle/foot domain of addons.  It seems that the majority of responses so far have been to “start over” with new MD documentation justifying the KAFO.  Thanks again for your sharp eyes and brain.
Bill Schumann, CPO/LPO

On Tuesday, March 18, 2014 1:38 PM, “ryderortho@aol.com” wrote:

L2330 code is used for Arizona type brace and is not suitable for your situation.
 
If you want to add uprights and drop locks to current AFO you could use L2036 but charge reduced rate since the AFO is already paid for, you could explain rate reduction in comments section.
 
If you feel AFO would not hold up well during the construction then you should request a new order.
 
Pat, Ryder Orthopaedics
—–Original Message—–
From: William Schumann
To: OANDP-L
Sent: Tue, Mar 18, 2014 1:29 pm
Subject: [OANDP-L] Coding question

Our facility provided a properly documented and prescribed L1960 for a Medicare
patient recently; within 3 yrs.  The Rx’ing MD now wants this AFO converted to a
KAFO L2036 with drop locks.  One opinion is to code L2330 ( does it have to be
laced?), L2405 X2 ( drop locks) but what about the side bars and joints?  Or, is
it better to consider original Rx inadequate for patient needs and have MD
submit his revised documentation stating why and code for the L2036 with L2405
X2?  Thanks for your opinions. Bill Schumann, CPO/LPO ********************
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