Medicare shoe billing questions
Randall McFarland, CPO
Description
Collection
Title:
Medicare shoe billing questions
Creator:
Randall McFarland, CPO
Text:
1) We've been told by Medicare that L3222 (high top shoes) is not recognized
anymore.
How do I bill for high top shoes now?
2) A while back, I submitted an extra 2.5 hour labor (L4305) billing for
significant extra modifications to a shoe/stirrup for a KAFO (welding a
medial extension on a long tongue stirrup and custom soleing for
weightbearing to accommodate a deformed foot/ankle). I included a thorough
description, photographs and pictures of X-rays of what we did. It came
back denied, saying that the extra work should be included as part of the
other procedures.
Q) Is this happening to everyone? Is there a way to get paid for shoe work?
3) Is a CMN required to get paid for shoes attached to an orthosis?
4) Is it wise to accept assignment for shoes and modifications?
Randy McFarland, CPO
anymore.
How do I bill for high top shoes now?
2) A while back, I submitted an extra 2.5 hour labor (L4305) billing for
significant extra modifications to a shoe/stirrup for a KAFO (welding a
medial extension on a long tongue stirrup and custom soleing for
weightbearing to accommodate a deformed foot/ankle). I included a thorough
description, photographs and pictures of X-rays of what we did. It came
back denied, saying that the extra work should be included as part of the
other procedures.
Q) Is this happening to everyone? Is there a way to get paid for shoe work?
3) Is a CMN required to get paid for shoes attached to an orthosis?
4) Is it wise to accept assignment for shoes and modifications?
Randy McFarland, CPO
Citation
Randall McFarland, CPO, “Medicare shoe billing questions,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 17, 2024, https://library.drfop.org/items/show/215918.
