Thursday, October 3, 2024

Re: Coding verification for AFOs

Paula Rogerson-Doherty

Just heard from Joe McTernan at AOPA…reply copied below…Good News!

We have been working this issue diligently and we have some positive news to report. The PDAC announced yesterday that they are postponing the coding verification requirement for the three custom codes indefinitely, pending further review by the DME MACs. The announcement is on the PDAC website at www.dmepdac.com. I just finished an article that will go out later today in the AOPA AIA Smartbrief newsletter.

Thanks,

Joe McTernan

Joseph McTernan
[email protected]

Paula Rogerson-Doherty
Business & Administrative Manager
Rogerson Orthopedic ~ Advanced Orthotic & Prosthetic Services
483 Southampton Street – PO Box 493
Boston, MA 02127
Ph: (617) 268-1135 Fx: (617) 269-3373
www.rogersonorthopedic.com

—–Original Message—–
From: Orthotics and Prosthetics List [mailto:[email protected]] On Behalf Of [email protected]
Sent: Monday, July 02, 2012 5:18 PM
To: [email protected]
Subject: [OANDP-L] Coding verification for AFOs

Everyone needs to read this. Looks like we all have to get coding verification for our AFOs under codes L1940, L1960, and L1970.

https://www.dmepdac.com/resources/articles/2012/05_16_12.html

Quoted from the above link :

“Custom fabricated by a supplier: These items are individually fabricated by a supplier from raw materials and are dispensed directly to the patient by the entity that fabricated the orthosis. For coding verification, the supplier must submit written documentation that lists the custom Ankle-Foot Orthosis (AFO) manufacturing processes and all components that will be a part of the base code for that AFO orthosis. The supplier must provide a narrative description of the item to include anatomical reference points, a list of the materials that were used and a description of the custom fabrication process (including photos of the process) used for this type of orthosis. These custom fabricated items must be listed on the PDACa?Ts DMECS in order to be billed using a custom fabricated code.”

Ted A. Trower CPO,
A-S-C Orthotics & Prosthetics
Jackson, MI
www.amputee.com

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