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Got FAQs?
By Lisa Lake-Salmon .jpg) Competitive bidding, NPI numbers, DX
Code updates, Medicare contractor reform, etc. Keeping up with the
new Medicare 2007 rules and regulation changes can become very
overwhelming. Count on "GOT FAQS" to keep you informed as you
prepare for O&P in 2007 and beyond.
Q: Can you tell me what the Medicare Part B
deductible will be for 2007? Also if a patient cannot afford the 20
percent Medicare co-pay, is it okay for me just to write these
charges off?
A: The Medicare Part B deductible for 2007 has
been increased to $131 per year. The law requires the provider to
make an effort to collect the 20 percent co-insurance payment. The
supplier must keep evidence on file of the attempt to collect this
from either the patient or the secondary insurance. The supplier
has an option of waiving the co-insurance in case of hardship;
however, a supplier cannot routinely waive the 20 percent
co-insurance payment for every patient.
Q: I have a patient who requires prefabricated
thermoformable liners. Can you let me know what codes I would use
to bill these items? The date of service for this claim is November
2006.
A: The correct coding for prefabricated
thermoformable liners is L-5673 (addition to lower extremity, below
knee/above knee, custom fabricated from existing mold or
prefabricated, socket insert, silicone gel, elastomeric or equal,
for use with locking mechanism); or L-5679 (addition to lower
extremity, below knee/above knee, custom fabricated from existing
mold or prefabricated, socket insert, silicone gel, elastomeric or
equal, not for use with locking mechanism).
Q: I am a region D provider who was receiving
payments from Medicare electronically. Recently I stopped receiving
these funds into my bank account and started receiving checks
again. What do I need to do in order to receive my funds directly
into my account again? Do you know why Medicare would have
stopped?
A: Noridian Administrative Services sent out
notifications to all providers to fill out a new CMS 588 form
(Electronic Funds Transfer) when they took over on 9/30/2006 for
DMERC D. If they did not receive the form back from you by December
1, 2006, they would have switched you back to receiving paper
checks. You need to fill out a new EFT form and send the original
agreement to Noridian Administrative Services, PO Box 6728, Fargo,
ND, 58108-6728. If you have any questions regarding the form, you
may send an e-mail to DME@noridian.com
We invite readers to ask questions regarding billing,
collections, or related subjects. For more information, contact lisa@opedge.com Acc-Q-Data provides
billing, collections, and practice management software and has
served the O&P industry nationwide for more than a
decade.
Lisa Lake-Salmon is Executive Vice President, Acc-Q-Data
Inc. 
Table Of Contents - January 2007
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