Add on codes for custom fit and OTS items
harrigans4
Description
Collection
Title:
Add on codes for custom fit and OTS items
Creator:
harrigans4
Date:
4/26/2018
Text:
Besides what is contained within Medicare’s Knee LCD about use of add on codes, I find no explicit guidance regarding use of add on codes with LE . I am referring to both Medicare and non Medicare.
In the AFO/ KAFO Medicare LCD “L code additions will be denied as not reasonable and necessary if either the base code is not reasonable and necessary or the specific addition is not reasonable and necessary. Is there any language in these documents ( or any) that states that the base code can only be a custom Lcode? If so please point me in that direction. I am aware the some add on codes are described as being “molded to model” I would exclude use of any add on code that explicitly uses molded to model language, however, most do not.
I have encountered many folks who say one cannot use add on codes when billing custom fit and OTS codes. Again, does anyone have any supportive documentation that explicitly says that use of add on codes are not “allowed” when billing these non custom codes? I am of course assuming if one were to use an add on code there is a documented justification for use of an add on. i.e. use of L1932 or L1951 and the use of L2820
I hope this creates some discussion as I cannot find anything, even on the dark web.
TY, Tom
Sent from Mail for Windows 10
In the AFO/ KAFO Medicare LCD “L code additions will be denied as not reasonable and necessary if either the base code is not reasonable and necessary or the specific addition is not reasonable and necessary. Is there any language in these documents ( or any) that states that the base code can only be a custom Lcode? If so please point me in that direction. I am aware the some add on codes are described as being “molded to model” I would exclude use of any add on code that explicitly uses molded to model language, however, most do not.
I have encountered many folks who say one cannot use add on codes when billing custom fit and OTS codes. Again, does anyone have any supportive documentation that explicitly says that use of add on codes are not “allowed” when billing these non custom codes? I am of course assuming if one were to use an add on code there is a documented justification for use of an add on. i.e. use of L1932 or L1951 and the use of L2820
I hope this creates some discussion as I cannot find anything, even on the dark web.
TY, Tom
Sent from Mail for Windows 10
Citation
harrigans4, “Add on codes for custom fit and OTS items,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/208846.
