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Got FAQs? By Lisa Lake-Salmon
Executive Vice President
Acc-Q-Data Inc.
The future of your practice depends on knowledgeable
billing and collection information. Understanding the full aspect
of billing guidelines and procedures will effectively increase your
reimbursement. This informative column will help providers and
their staff with a better understanding of billing procedures and
reimbursement strategies.
Q: I am a relatively new prosthetist and was wondering
if Medicare will cover repairs or adjustments made to a patients
prosthesis?
A:Any repairs or adjustments made to the
prosthesis within the first 90 days of fitting are not paid for
separately; Medicare considers that included in the reimbursement
for the prosthesis. After the initial 90 days, you would then use
either L-7510 (repair) and/or L-7520 (labor per 15 minutes). You
will need to explain to Medicare in your additional documentation
exactly what the repairs were for. Remember to always use the
proper modifiers: RP (repair), RT or LT (specifies which leg), K1
K2 K3 or K4 (what functional level).
Q: I heard through the grapevine that Medicare will now
reimburse for compression stockings. Can you let me know if this is
true?
A: Effective October 1, 2003, Medicare began
reimbursing for L-8110 (Gradient compression stocking below knee,
30-40 mmHG and
L-8120 (compression stocking, 40-50 mmHG). This may be covered
under the surgical dressing benefit when it is used to secure a
primary dressing over an open wound or venous stasis ulcer that has
debridement, and when the gradient stocking can be proven to
deliver compression greater then 30 mmHG and less then 50 mmHG. You
must use either the RT or LT modifier along with the AW
modifier.
We invite readers to ask any questions you have regarding billing,
collections, or any other related information. To send your
questions or for more information, contact: lisa@westernmediallc.com
Acc-Q-Data provides billing, collections and practice management
software, serving the O&P industry nationwide for over a
decade.
Table Of Contents - January 2004
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