Reimbursement Q&A
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 receive many requests to deliver items to
patients while they are in the hospital, and I find I have a hard
time being paid for these services by Medicare.
A: According to DMEPOS, you may deliver items
to a patient during an inpatient stay at a hospital, as long as the
delivery date is within two days prior to discharge and the item is
needed for fitting and training purposes. When billing Medicare,
your date of service should be the patient's discharge date,
instead of date of delivery. Your place of service should either be
11 (office) or 12 (home). You should have all the proper
documentation in the patient file to support this information.
Q: I sometimes make modifications to a prefabricated
item to fit a patient's needs. Can I bill Medicare for labor or
repair for this?
A: According to DMERC, a provider may only bill
for time involved with the actual repair of an orthosis or
prosthesis for medically necessary adjustments made more than 90
days after delivery.
Q: Can a provider have access to the history of a
patient to determine if they have received same or similar items in
the past?
A: A provider may contact the Caller
Information Network (CIN) with the beneficiary on the line. If the
beneficiary grants permission to release this information to you,
then the Medicare representative can supply the patient's history
to you.
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 - December 2004
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