Many insurance companies claim to adhere to Medicare guidelines when
contracting with O&P providers, yet they will sometimes provide their own list of
codes for reimbursement purposes. These code lists often do not include every
Medicare-listed code, however. Is this legal? It seems to be a very common
practice, and it makes the coding of claims very difficult when you can’t use
the correct code out of fear that you will be denied since the particular
code is not on the insurance company’s list. I welcome any thoughts…
John Dunn
Marketing Director
Academy O&P Associates
[email protected]_ (mailto:[email protected])
