L4205 & L4210 &...999 codes
Michael P Madden
Description
Collection
Title:
L4205 & L4210 &...999 codes
Creator:
Michael P Madden
Date:
3/9/2000
Text:
Dear colleagues,
Over the past 1-2 years we have had intermittent success billing
(electronically) the codes requiring descriptions for reimbursement.
Specifically, the L4205 labor codes, the L4210 parts codes, and the
...999 codes (among others). We have been in contact with Medicare per
their requirements, and have tried to meet their requests (often getting
a different requirement depending on who we talk to), but find it is a
hit or miss process. We have not altered our narratives to any great
extent, (only by what has been requested), and find that sometimes we are
paid, and sometimes not. It almost seems to depend on who is reviewing
the narrative.
One of our biggest problem is billing minor replacements/adjustments
which require replacements and/or adjustments of custom fabricated items.
They keep asking for invoices, for items for which no purchase invoice
exists!! We have tried to explain this is a custom fabrication item not
an item which has been purchased. Even when we try to narrate this (with
what limited space we are provided electronically), we are SOMETIMES
rejected for lack of information, and sometimes paid. Replacing a
joint or other component supplies an invoice, replacing a strap, molded
face shield on a custom helmet or similar fabrication item does not, and
seems to be a gamble.
The ...999 code are a nightmare in and of themselves. We do a lot of
very specialized fabrications which are not even within the consideration
of the L-code descriptors. To avoid any interpretation/misinterpretation
of the fallacy of close enough codes, we bill them as ...999 codes with
a descriptor. Again it seems to be a hit or miss process.
HHHHHHHHHHHHHHEEEEEEEEEEEEEEEEEEELLLLLLLLLLLLLLLLLLLLLLPPPPPPPPPPPPPPPP!!
!!!!!!!!!!!!!!!!!!!!!!
Please forward experiences, hints,successes, failures....information to
help us improve our legitimate reimbursement for services rendered.
I will post responses, if you want your names removed please request so.
Thanks in advance...
Mike M.
________________________________________________________________
YOU'RE PAYING TOO MUCH FOR THE INTERNET!
Juno now offers FREE Internet Access!
Try it today - there's no risk! For your FREE software, visit:
<URL Redacted>.
Over the past 1-2 years we have had intermittent success billing
(electronically) the codes requiring descriptions for reimbursement.
Specifically, the L4205 labor codes, the L4210 parts codes, and the
...999 codes (among others). We have been in contact with Medicare per
their requirements, and have tried to meet their requests (often getting
a different requirement depending on who we talk to), but find it is a
hit or miss process. We have not altered our narratives to any great
extent, (only by what has been requested), and find that sometimes we are
paid, and sometimes not. It almost seems to depend on who is reviewing
the narrative.
One of our biggest problem is billing minor replacements/adjustments
which require replacements and/or adjustments of custom fabricated items.
They keep asking for invoices, for items for which no purchase invoice
exists!! We have tried to explain this is a custom fabrication item not
an item which has been purchased. Even when we try to narrate this (with
what limited space we are provided electronically), we are SOMETIMES
rejected for lack of information, and sometimes paid. Replacing a
joint or other component supplies an invoice, replacing a strap, molded
face shield on a custom helmet or similar fabrication item does not, and
seems to be a gamble.
The ...999 code are a nightmare in and of themselves. We do a lot of
very specialized fabrications which are not even within the consideration
of the L-code descriptors. To avoid any interpretation/misinterpretation
of the fallacy of close enough codes, we bill them as ...999 codes with
a descriptor. Again it seems to be a hit or miss process.
HHHHHHHHHHHHHHEEEEEEEEEEEEEEEEEEELLLLLLLLLLLLLLLLLLLLLLPPPPPPPPPPPPPPPP!!
!!!!!!!!!!!!!!!!!!!!!!
Please forward experiences, hints,successes, failures....information to
help us improve our legitimate reimbursement for services rendered.
I will post responses, if you want your names removed please request so.
Thanks in advance...
Mike M.
________________________________________________________________
YOU'RE PAYING TOO MUCH FOR THE INTERNET!
Juno now offers FREE Internet Access!
Try it today - there's no risk! For your FREE software, visit:
<URL Redacted>.
Citation
Michael P Madden, “L4205 & L4210 &...999 codes,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/213857.
