Billing "A" codes -responses
Description
Collection
Title:
Billing "A" codes -responses
Text:
The posted question:
In the discussion of shoes for diabetics, mention was made of billing A5502
Is that a code only physicians can bill, or is it for participating
facilities with the diabetic shoe program? I thought we can't bill A
codes, only L codes.
end of post
(My facility is not participating in the therapeutic shoe program)
Responses received: Thanks to everyone who responded!!
Where have you been? If you are a medicare provider A-codes are the only
codes you are supposed to use for diabetics. The Diabetic Shoe Bill, passed
some three years ago, mandated that providers utilize the A-codes and secure
the appropriate HCFA medical necessity letter from the physician treating the
patient for their diabetes or their foot complications. I suggest you contact
your regional carrier for the specific guidelines or give the national office
a call for the details. You might want to consider attending an AOPA
sponsored coding seminar as well. They do an excellent job of covering the
ins and outs of billing for diabetic shoes etc. Good luck.
The A Codes are for billing diabetic shoes. They can be used by Orthotists
and Prosthetists. They have been in existence for at least 4-years and have
been prominently mentioned throughout the AOPA news releases and in the
Coding Seminar.
Here in Florida, we can bill A codes and in fact do often. We do have to
jump through
some hoops to show meet the requirements of the diabetic shoe program. (Have
proper forms and
Rx). This should be in your medicare updates.
Use A code for the Medicare Therapeutic Shoe Program. Check you Supplier's
Manual. A5500, A5501, A5502, A5503, A5504, A5505, A5506 and A5507. These are
the only A code that I know are billable by P and O.
A codes have been designated by HCFA as the proper codes to use when billing
Medicare for diabetic shoe or shoe modifications, If you want to be paid for
this type of orthotic intervention you must use these codes. You are also
required to get supporting documentation from the Doctor who treats the
patient for their diabetes.
When billing medicare for shoe stuff, one must use the various A-codes
assigned to them. The quick remedy for discovering which A-codes to use is
to contact Tru-Fit shoes and have them send information on their diabetic
shoe program for medicare reimbursement.
I find this really quite different to the situation in the UK. I work in
the North east of england and in Edinburgh in Scotland as an Orthotist. I
am duel qualified and state registered as a Prosthetist/Orthotist with 2
years experiance after graduation.
Orthotic footwear forms a major part of my work perhaps 30-40% of all my
patients are seeing me for some sort of footwear. I can order stock
footwear from a wide range of manufacturers or, if required, measure for
custom made footwear to be manufactured at our companys factory.
I look at Orthotic Footwear as being much more than 'extra depth'.
(although this is a term I haven't heard much before) Its prescribed for
Orthopaedic, Rhumatiod and the Diabetic foot and each condition requires a
different design of footwear (including insoles).
On the commercial side, I work for a private company whose Orthotic
services
are purchased by each NHS trust. We charge the trust for each orthotic
device issued and the pricing of this reflects the cost of the item, the
orthotists time, the cost of the admin staff etc.
feel free to visit our website:www.peacocks.net
We are specifically directed to bill A codes by HICFA (Medicare
administrators). The original info was an addendum in 1997, but now the info
should be in the very last pages of your billing description book from
Medicare.
If you have an NSC supplier number, you can bill any of the alpha-numeric
HCPCS Level II codes. This is part of AOPA's battle to limit billing use
of the L codes to only certified or trained (not the exact/official words)
orthotists and prosthetists. When you are billing for therapeutic shoes
for a diabetic patient who qualifies for the Medicare Therapeutic Shoe
program, you have to use the A codes. I will refer you to the medical
policy section in your DMERC Supplier Manual for Therapeutic Shoes.
In the discussion of shoes for diabetics, mention was made of billing A5502
Is that a code only physicians can bill, or is it for participating
facilities with the diabetic shoe program? I thought we can't bill A
codes, only L codes.
end of post
(My facility is not participating in the therapeutic shoe program)
Responses received: Thanks to everyone who responded!!
Where have you been? If you are a medicare provider A-codes are the only
codes you are supposed to use for diabetics. The Diabetic Shoe Bill, passed
some three years ago, mandated that providers utilize the A-codes and secure
the appropriate HCFA medical necessity letter from the physician treating the
patient for their diabetes or their foot complications. I suggest you contact
your regional carrier for the specific guidelines or give the national office
a call for the details. You might want to consider attending an AOPA
sponsored coding seminar as well. They do an excellent job of covering the
ins and outs of billing for diabetic shoes etc. Good luck.
The A Codes are for billing diabetic shoes. They can be used by Orthotists
and Prosthetists. They have been in existence for at least 4-years and have
been prominently mentioned throughout the AOPA news releases and in the
Coding Seminar.
Here in Florida, we can bill A codes and in fact do often. We do have to
jump through
some hoops to show meet the requirements of the diabetic shoe program. (Have
proper forms and
Rx). This should be in your medicare updates.
Use A code for the Medicare Therapeutic Shoe Program. Check you Supplier's
Manual. A5500, A5501, A5502, A5503, A5504, A5505, A5506 and A5507. These are
the only A code that I know are billable by P and O.
A codes have been designated by HCFA as the proper codes to use when billing
Medicare for diabetic shoe or shoe modifications, If you want to be paid for
this type of orthotic intervention you must use these codes. You are also
required to get supporting documentation from the Doctor who treats the
patient for their diabetes.
When billing medicare for shoe stuff, one must use the various A-codes
assigned to them. The quick remedy for discovering which A-codes to use is
to contact Tru-Fit shoes and have them send information on their diabetic
shoe program for medicare reimbursement.
I find this really quite different to the situation in the UK. I work in
the North east of england and in Edinburgh in Scotland as an Orthotist. I
am duel qualified and state registered as a Prosthetist/Orthotist with 2
years experiance after graduation.
Orthotic footwear forms a major part of my work perhaps 30-40% of all my
patients are seeing me for some sort of footwear. I can order stock
footwear from a wide range of manufacturers or, if required, measure for
custom made footwear to be manufactured at our companys factory.
I look at Orthotic Footwear as being much more than 'extra depth'.
(although this is a term I haven't heard much before) Its prescribed for
Orthopaedic, Rhumatiod and the Diabetic foot and each condition requires a
different design of footwear (including insoles).
On the commercial side, I work for a private company whose Orthotic
services
are purchased by each NHS trust. We charge the trust for each orthotic
device issued and the pricing of this reflects the cost of the item, the
orthotists time, the cost of the admin staff etc.
feel free to visit our website:www.peacocks.net
We are specifically directed to bill A codes by HICFA (Medicare
administrators). The original info was an addendum in 1997, but now the info
should be in the very last pages of your billing description book from
Medicare.
If you have an NSC supplier number, you can bill any of the alpha-numeric
HCPCS Level II codes. This is part of AOPA's battle to limit billing use
of the L codes to only certified or trained (not the exact/official words)
orthotists and prosthetists. When you are billing for therapeutic shoes
for a diabetic patient who qualifies for the Medicare Therapeutic Shoe
program, you have to use the A codes. I will refer you to the medical
policy section in your DMERC Supplier Manual for Therapeutic Shoes.
Citation
“Billing "A" codes -responses,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/212745.
