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 staffwith a better understanding of billing
procedures and reimbursement strategies.
Q: For Medicare purposes, are we allowed to accept
assignment for some items and not for others? We have been under
the impression that it is either all or nothing.
A: If your status with Medicare is
non-participating, then you can choose whether to accept assignment
on a claim-by-claim basis. If you are participating, then you must
accept assignment on all claims. If you are not sure of your
status, you may contact your DMERC. Your DMERC can let you know
your current status with it.
Q: The podiatrist I work for has just started
billing for custom-molded therapeutic shoes and inserts. I know the
codes I use for billing, but I am not sure of the modifiers. Please
advise me on the correct coding. Also, with code L-4396, do I use
KX and RT or LT?
A: When billing A-5501 and K-0629, you use the
KX modifier. For K-0629, you need to bill two units for each pair
of inserts you provide. When billing L-4396, you use either the RT
or LT modifier only.
Q: How would a provider of O&P services know
what specialty code should be on file with DMERC? Do you have a
list of the codes with their descriptions?
A: Qualified specialties and their codes are
listed as follows: Medical Supply Company with Orthotics Personnel
(51), Medical Supply Company with Prosthetics Personnel (52),
Medical Supply Company with Orthotics and Prosthetics Personnel
(53), Orthotics Personnel (55), Prosthetics Personnel (56),
Orthotics Personnel, Prosthetics Personnel, and Pedorthists
(57).
We invite readers to ask any questions you may 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. For more information contact lsalmon@acc-q-data.com
Lisa Lake-Salmon is Executive Vice President, Acc-Q-Data,
Inc. 
Table Of Contents - June 2005
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