"Reimbursement issues..." Response summaries

Phil Meyers, CO

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Title:

"Reimbursement issues..." Response summaries

Creator:

Phil Meyers, CO

Text:

Thanks to all who are sending in replies. This is a very important topic for
our profession and one we should strive to navigate a path through. The
L-code structure might have been good at one time but no longer addresses the
needs of it's users and it sets us all up for litigation.

I'll post more responses as they roll in...
Sincerely,
Phil Meyers, CO


BTW, I am also the moderator of AMP-L a University of Washington and
would like permission to cross-post your query....If that is OK?
-----------------------------
I am not a CP or CPO but I am an amputee (R-BK) and I find your
question(s) to be thoughtful and well put. I will be most interested to
read your summary of responses, a number of which, I have little doubt,
will be anonymous :) But in this case, it is the honest ideas and
comments that might emerge that most matter.
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Phil,
In times past we were allowed to use a procedure followed by a (-52) as a
modified to pull the fee out of profile for allowable fee determinations, and
then charge an amount less than what medicare allowed.

It seems that it still exists, but I'm not sure, I suggest you contact Kathy
Dodson via the National Office. She is the resident Medicare expert.
-----------------------------
Phil,
I too see this as an issue. At one time the Academy had a terminology and
nomenclature committee, to try and address this type issue. I have advised
the President we need to be working on this. As Vice president, and off the
record, I would like to ask you to inquire via the ask the president or
direct communication to me and cc the president, requesting the Professional
issues council address this issue.

I have at least one other person who has done some work on this issue, and
would like to work on some accepted terminology or phrasing to standardize
within the current system what we call an xyz as an Lxx0x.

                          

Citation

Phil Meyers, CO, “"Reimbursement issues..." Response summaries,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/214164.