Tuesday, October 15, 2024

Re: PRAFO and multipodus boot billing for Medicare

Jason Auyer

Hello list,

Here is my original question:

>
> I was wondering if anyone has any suggestions for billing Medicare Part B
> for a multipodus boot or PRAFO to specifically offload plantar diabetic
> ulcers. From my understanding medicare will only pay for L4396 for either
> PF contractures, or plantar fascitis, even though the descriptor for the
> code falls in line for pressure reduction (from how I read it). Therefore,
> the only code that can be used for Medicare for these situations is A9283,
> which is a non-covered code. Therefore, any Medicare patient would have to
> sign an ABN and end up paying out of pocket for these items.
>
> Is there anything that I am missing or any other suggestions for how to
> properly bill Medicare for this item.
>
> Thank you,
>

Just about every response said I was doing this correctly and many shared
my frustration with how medicare has chosen to handle this code. Thanks
list.

>
>
> —
> Jason Auyer, LCP, LCO
> Licensed Certified Prosthetist, Licensed Certified Orthotist
> Atlanta Prosthetics and Orthotics
> 1100 Sherwood Park Drive
> Suite 220
> Gainesville, GA 30501
> ph: (770) 287-2395
> fax: (770) 287-2398
> www.atlantapo.com
>


Jason Auyer, LCP, LCO
Licensed Certified Prosthetist, Licensed Certified Orthotist
Atlanta Prosthetics and Orthotics
1100 Sherwood Park Drive
Suite 220
Gainesville, GA 30501
ph: (770) 287-2395
fax: (770) 287-2398
www.atlantapo.com

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