Got FAQs?
By Lisa Lake-Salmon  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 have recently received numerous denials when
billing L-0500 and have always been paid for this in the past. Do
you know why I was denied?
A: Effective for dates of service on or after
April 1, 2004, L-0500 is no longer a valid code. It has been
replaced with K-0634.
Q: If there is a Medicare allowable, can a provider
charge for an item when the manufacturer does not charge for it
separately?
A: The provider cannot bill Medicare when the
manufacturer's invoice does not reflect a separate charge for the
item in question.
Q: I received a denial from a commercial insurance
carrier stating authorization was needed. Will Medicare, which is
secondary, pay for this claim?
A: Unfortunately, if you do not follow the
proper procedures with the patient's primary insurance in obtaining
authorization, Medicare will not pay for your claim.
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. Lisa Lake-Salmon is Executive Vice President of Acc-Q-Data Inc. 
Table Of Contents - November 2004
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