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: I recently provided a service to a patient for
which I will be using the new code of K-0670 that became effective
on April 1, 2005. I have been unable to locate the allowable for
the state of Illinois. Can you please direct me to where I may find
this information?
A: According to DMERC Region B, the allowable
for Code K-0670 (Addition to lower extremity prosthesis,
endoskeletal knee shin system, microprocessor control feature,
stance phase only, includes electronic sensor, any type), is
$9,679.24. This information is now listed in the 2005 April
Quarterly DMEPOS Fee Schedule Update.
Q: I have been billing codes
K-0646 and K-0648, which are replacement codes for the old L-0565,
but I have been using the old fee schedule. Has Medicare updated
the K-Codes to new prices, or have they remained the
same?
A: When Medicare replaced the Code L-0565 with
the new K-Codes, which took effect on January 1, 2005, the fee
schedule amounts crossed over as well. You are billing correctly by
using the old allowable amount with the new Codes K-0646 and
K-0648.
Q: I had billed Medicare about a year ago with a
claim that was denied for CO- 50 (Not medically necessary). This
claim had fallen through the cracks in my office, and when I came
across the claim again, I tried to re-submit the claim with the
corrected information to Medicare. The claim was denied again for
duplicate claim. Is there additional action I can take to get this
claim paid by Medicare?
A: Unfortunately there is nothing that you can
do. For any claim that receives a denial code of CO-50, you only
have 120 days to submit the claim into review from the original
denial date. Since your claim was re-submitted later than the 120
days, Medicare denied it as a duplicate and will not process your
claim for payment.
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.
Lisa Lake-Salmon is Executive Vice President, Acc-Q-Data,
Inc. 
Table Of Contents - July 2005
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