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 provided a knee brace to a patient ten months
ago, and now the patient says it does not fit properly, so he would
like to return it. Am I required to take the brace back from the
patient after ten months? Medicare paid for this
brace.
A: Since the patient has had the brace for ten months, you are
not required to take it back. If you let the patient return the
brace, Medicare can request a refund on the monies paid to you.
Q: I have a patient who has plantar fasciitis and
requires a night splint. Is this type of orthotic covered by
Medicare, and do you know what code I would use to
bill?
A: A night splint is covered under the AFO policy as a static
ankle-foot orthosis. The HCPCS code is L-4396. Please note the
ICD-9 code for plantar fasciitis is 728.71.
Q: I heard that Medicare will now reimburse for
compression stockings. Can you let me know if this is
true?
A: Effective Oct 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 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 - August 2004
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