Got FAQs?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 new provider of
diabetic shoes and inserts and would like to know how many of each
item is a patient allowed per year.
A: Patients who meet the coverage criteria may
receive the following each calendar year: one pair of custom-molded
shoes (A-5501) or one pair of depth shoes (A-5500). One pair of
inserts is included with the A-5501, and the patient may get two
additional pairs of inserts (A-5509 or A-5511). A-5500 does not
include a pair of inserts; therefore, you may provide the patient
with three pairs of inserts.
Q: I received an overpayment request that I
disagree with. If I appeal the request, do I still have to refund
the money to Medicare?
A: Yes. A request for an appeal will not alter
the overpayment request. If an appeal results in a partially or
fully favorable decision, an appropriate refund will be made to the
provider. Any overpayment due to Medicare should be made within 30
days after the first demand letter.
Q: I heard that the K-Codes for the gel liners
have been changed back to L-Codes. Is this true? If so, do you know
the codes and when they become effective?
A: Effective January 1, 2004, the K-Codes for
gel liners are once again L-Codes: K-0556 has been changed to
L-5673; K-0557 has been changed to L-5679; K-0558 has been changed
to L-5681; and K-0559 has been changed to L-5683. However, the
description for the codes remains the same.
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 and has been serving the O&P industry
nationwide for over a decade. 
Table Of Contents - March 2004
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