Saturday, May 18, 2024
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DME coding dilemma

Padmavathi S. Annaldasula

Hi,

Medicare does not accept an L code because a PDAC letter is required but
commercial payors have no such requirement. So question is do you change the
code for commercial too just because Medicare criteria is not met…? It’s a
grey area because per coding guidelines you have to be consistent in billing
the right code. What is your opinion about this.

Thanks,

Padma Annaldasula CPC

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