Whether you have a question about L-Codes, documentation, or claim denials, count on Got FAQs? to help keep your O&P shop running smoothly.
Q: Recently, you published a question that was directed at additions to L-1845. Are the same addition codes (L-2385, L-2395, L-2397, and L-2795) allowed when billed with base codes L-1800 and L-1820?
A: Effective July 1, 2008, there are no addition codes eligible for separate payment when billed with L-1800 and L-1820 as the base code. More information about the new knee orthoses policy can be found on the Centers for Medicare & Medicaid Services (CMS) website at ( www.cms.gov/mcd/viewlcd.asp?lcd_id=22664&lcd_version=2&show=all ).
Q: I am a provider in Region C and was wondering how long I am required to keep my patient files. My office manager says it is five years, but I thought I had to keep all records longer than that. I am approaching the end of my fifth year in business and do not want to dispose of any records until I am certain of the answer.
A: As stated in the DME MAC Jurisdiction C supplier manual, suppliers are required to maintain documentation records on file for seven years.
Q: I am billing an Otto Bock C-Leg for the first time, and want to make sure I am billing all the L-Codes for this item correctly. I do not want to have my payment delayed due to incorrect coding.
A: On June 27, 2008, Cigna Government Services released a coding publication regarding the coding instructions for the Otto Bock C-Leg. According to SADMERC, the only HCPCS codes billable for the Otto-Bock C-Leg are L-5828, L-5845, L-5848, L-5856, L-5920, L-5930, and L-5950. The coding instructions are available online at www.cignagovernmentservices.com/jc/pubs/news/2008/0608/cope7892.html
Q: I submitted a claim to Medicare for L-1858, and my claim was denied for an invalid procedure code. I thought this was a valid code. Am I missing something?
A: Effective January 1, 2008, L-1858 (knee orthosis, molded plastic, polycentric knee joints, pneumatic knee pads (CTI), custom fabricated) is no longer a valid code. The code was replaced by L-1846. Likewise, codes L-1855, L-1870, and L-1880 have been discontinued and replaced by L-1846.
Authors note: This months column is dedicated to my mother, Barbara Lake, whose words of wisdom and compassion for others will be greatly missed by all.
Lisa Lake-Salmon is the executive vice president of ACC-Q-Data, which provides billing, collections, and practice management software and has been serving the O&P profession for more than a decade. We invite readers to write in and ask any questions they may have regarding billing, collections, or related subjects. For more information, contact
