Tuesday, July 16, 2024

Responses to Billing Prosthetics in SNF

Posted Question

It is my understanding that we can now provide prosthetic care in nursing

>homes. I just received a prosthetic order for a medicare patient in a SNF.

>Am I correct that medicare can be billed for this prosthesis??

>

RESPONSES

There are specific prosthetic codes that are excepted from the PPS rules.

Prosthetic socks are not among them.

Under Part B, you are OK.

Yes Dave– as of April 1,2000 You can bill medicare B for a prosthesis

provided for a patient in Nursing home that is currently under Medicare A

coverage for all other care. This is not true for orthotic services

Please post an answer if you get one because I was

under the impression that the “three day rule” still

is in effect. This is a vital issue to all of us who

have experienced the refusal of SNF’s to play by the

rules for their patients

Yes, as long as your date of service is on or after April 1, 2000 and the

codes you use are on the list of codes excluded from SNF PPS. You can find

these in the AOPA In Advance of May 23, 2000.

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