Anthem

Stephanie Sheedy

Description

Title:

Anthem

Creator:

Stephanie Sheedy

Date:

2/7/2018

Text:

In my area, Anthem (Commerical and Medicaid product) has the prosthetic
parts code, L7510, listed as a fixed reimbursement code paying a very small
dollar amount. I contacted my contract representative to explain this is a
variable code and below is the response I received. I would advice others
to check the reimbursement for this code to see if this is happening across
the board.

This has never come before in the years I am here with any other O&P
provider across Anthem so I am going to touch base with an a certified
coder here at Anthem to confirm this for me. If it needs to be set like an
NOC code as you state, I will then need to engage the fee schedule
leadership team to make the necessary changes. That will be a lengthy
process as job aids need to be built surrounding the handling of this code
as a manual process across all 14 Anthem states, not just in WI or MO.
--



*Stephanie Sheedy*

President

Monroe BioTechnology, Inc.

920-435-3002

www.monroebiotech.com

email: <Email Address Redacted>

                          

Citation

Stephanie Sheedy, “Anthem,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 23, 2024, https://library.drfop.org/items/show/208678.