Medicare RUL AFO vs Repairs

Medicare RUL AFO vs Repairs

Kassie Harnden

5/9/2019

Hello! My understanding that if a custom AFO breaks and is un able to be fixed and has to be replaced completely, if it’s within the Medicare 5 year RUL we are un able to bill for a new AFO. We have to bill for parts/labor up until 60% of the cost of a billing for a new one. – I am not positive on that % but it’s what came to mind.

I am looking for feedback on if this is what others understand the policy to be and how do you handle these in your office. What is your process for coding units of parts/labor?

Region D MCR

Thanks in advance!


[OrthoMedics Omaha]

Kassie Harnden

Director of Operations | OrthoMedics Omaha

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