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 was recently contacted by a patient whose brace
was destroyed during a hurricane. Would Medicare pay for another
brace?
A: Yes, Medicare will pay for another brace.
You need to file a hardcopy claim with documentation stating the
nature of the disaster and the damage the brace suffered. At the
top of the claim form, indicate in large bold letters "Disaster
Claim" and the nature of the disaster, e.g., "hurricane claim."
Q: I am the billing representative
in our office and cannot seem to figure out why I keep getting
CO-50 denials from Medicare for L-5980. I bill this with the other
component, L-5540, for which I receive payment.
A: The L-5980, Flex-Foot®
system, is not meant to be used with the L-5540 code, which is for
a below-knee prosthesis with a SACH foot interface. The coverage is
according to the functional levels: L-5980 is level 3 and L-5540 is
level 1.
Q: I read your column last month and am curious what
the codes are for billing the labor on a repair for a prosthetic or
orthotic item. Can you give those?
A: The code for labor on an orthotic repair is
L-4205. The code for labor on a prosthetic device is L-7520. These
are for 15-minute intervals. Again, this is the time involved for a
repair or adjustment made at least 90 days after delivery.
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 - February 2005
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