Got FAQs?

By Lisa Lake-Salmon

The future of your practice depends on knowledgeable billing and collection information. Understanding the full aspect of billing guidlines 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: Is a walking boot covered by Medicare? If so, when would it be covered and what code would I use to bill?

A: L-4360 and L-4386 are ankle-foot orthoses that are referred to as prefabricated walking boots. If the walking boot is used to provide immobilization as treatment for an orthopedic condition or following orthopedic surgery, it would be eligible for coverage under the brace benefit. When walking boots are used to relieve pressure, or are used for patients with foot ulcers, they are noncovered and you must add a GY modifier.

Q: I am a new provider of diabetic shoes and have heard that the codes for inserts are no longer A-Codes. Is this true? If so, do you know the new codes?

A:Effective for dates of service on or after April 1, 2004, A-5509 will be changed to K-0628, and A-5511 will be changed to K-0629.

Q: As an O&P provider, I know I need a business associate agreement, but I am not sure whom I should have one with.

A: A business associate is an organization or person, other than a member of a covered entity's workforce, who receives electronic protected health information (PHI) to provide services to, or on behalf of, a covered entity. This would include: software vendors, billing services, accountants that view patient information, legal services that assist in patient cases, and management firms that review patient information within the organization. The common thread is that these organizations are not employees of your company, but they assist in managing patient information in one form or another.

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.

Lisa Lake-Salmon is Executive VP of Acc-Q Data, Inc.

	Billing and Collections Q&A - June 2008 Got FAQs?
	Billing and Collections Q & A - May 2008 Got FAQs?
	Got FAQs? - April 2008 Got FAQs?
	Got FAQs? - March 2008 Got FAQs?
	Got FAQs? - February 2008 Got FAQs?
	Got FAQs? - January 2008 Got FAQs?
	Billing and Collections Q&A - December 2007 Got FAQs?
	Billing and Collections Q&A - November 2007 Got FAQs?

Table Of Contents - May 2004

	Phantom Pain: Unlocking a Mystery An accomplished amateur athlete named John had lost his left arm just below the elbow. “When I play tennis, my phantom will do what it’s supposed to do,” John said. “It’ll want to throw the ball up when I serve or it will give me balance in a hard shot. It’s always trying to grab the phone. It even waves for the check in restaurants,” he laughed. Feature
	ContourMed Scanning Technology: A New Option for Post-Mastectomy Patients Innovations
	Robert E. Arbogast–The Third Generation of Ohio Willow Wood Unfolds Industry Leaders
	Got FAQs? Got FAQs?
	Young Prosthetists Enhance Skills in Ecuador “I learned to problem-solve without conventional means. It was like taking the textbook principles and applying them as far outside the box as possible...” Global View
	Ghanaian Helps Disabled Countrymen Salute!
	John E. Messer, CO Profile
	Where Should Our Focus Really Be? Perspective
	From the Editor: Hard Questions, No Easy Answers Viewpoints