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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 received a front-end denial for L-3963 stating
procedure code or modifier invalid for date of service and do not
understand why this would be denied since I have billed in the past
and was paid for this code.
A: Your claim was denied because as of January
1, 2006, procedure code L-3963 (shoulder elbow wrist hand orthosis,
molded with articulating elbow joint custom fabricated) was deleted
and replaced with either L-3971 or
L-3973.
Q: I am a provider located in Region B, and I recently
heard the codes for compression stockings have changed. Is this
true? If so, what are the new codes, and when did this change
become effective?
A: Yes, it is true that effective January 1,
2006, the changes for compression stockings are as follows:
L-8100 (new code A-6530), L-8110
(A-6531), L8120 (A-6532), L-8130
(A-6533), L-8140 (A-6534), L-8150
(A-6535), L-8160 (A-6536), L-8170
(A-6537), L-8180 (A-6538), L-8190
(A-6539), L-8195 (A-6540), L-8200
(A-6541), L-8210 (A-6542), L-8220
(A-6543), L-8230 (A-6544), L-8239
(A-6549).
Q: I was informed by the manufacturer to bill for
K-0618 and K-0619 for services I provided, and received a denial
(CO-16) from Medicare. I am a new O&P provider, and I do not
understand why my claim would be denied.
A: You stated you received a CO-16 (claims
lacks information). If your date of service is after January 1,
2006, your claim was denied for CO-16 because these codes are no
longer valid and were replaced as follows: K-0618 was changed to
L-0491; and K-0619 was changed to
L-0492.
We invite readers to ask questions you have regarding billing,
collections, or any other information. To send your questions or
for more information, contact: lisa@opedge.com
Acc-Q-Data provides billing, collections, and practice management
software serving the O&P industry nationwide for more than 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 - March 2006
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