Responses: Suspension sleeves
Description
Collection
Title:
Responses: Suspension sleeves
Text:
Thanks to all who responded.
Our office manager tells me that at a recent AOPA coding seminar this issue
was discussed. Essentially the only option discussed was L-5999. As we
understand it if this code is used and denied by Medicare you cannot re-bill
under a different code and you cannot charge the patient unless the patient
is informed (in writing, signed by the patient) that it may be denied and why
it may be denied. Below is my original post followed by the responses I
received.
Original post:
I have found some of the new suspension sleeves (Iceflex, TEC Prolink, Alps,
etc.) to be far superior in function and durability and have witnessed fewer
problems with dermatitis compared to latex or neoprene sleeves for many of
our BK suspension sleeve wearers. The only L-codes I'm aware of for BK
suspension sleeves are 5674 and 5675 which are latex sleeve suspension or
equal. I do not consider these sleeves and/or there materials, silicone,
urethane, etc., to be equal to latex. I'm not sure however, if or how you can
properly code them otherwise. If anyone has knowledge of other proper codes
available or experience successfully coding these sleeves (5999 or otherwise)
I would appreciate your input or suggestions.
Thank you,
Eddie White, CP
Beacon P&O
Responses:
The manufacturers have to apply for a different L-Code and they are not doing
it. Perhaps if they hear from more clinicians who threaten to not buy the
products unless they help US get a better reimbursement, then they will
respond.
Our office manager tells me that at a recent AOPA coding seminar this issue
was discussed. Essentially the only option discussed was L-5999. As we
understand it if this code is used and denied by Medicare you cannot re-bill
under a different code and you cannot charge the patient unless the patient
is informed (in writing, signed by the patient) that it may be denied and why
it may be denied. Below is my original post followed by the responses I
received.
Original post:
I have found some of the new suspension sleeves (Iceflex, TEC Prolink, Alps,
etc.) to be far superior in function and durability and have witnessed fewer
problems with dermatitis compared to latex or neoprene sleeves for many of
our BK suspension sleeve wearers. The only L-codes I'm aware of for BK
suspension sleeves are 5674 and 5675 which are latex sleeve suspension or
equal. I do not consider these sleeves and/or there materials, silicone,
urethane, etc., to be equal to latex. I'm not sure however, if or how you can
properly code them otherwise. If anyone has knowledge of other proper codes
available or experience successfully coding these sleeves (5999 or otherwise)
I would appreciate your input or suggestions.
Thank you,
Eddie White, CP
Beacon P&O
Responses:
The manufacturers have to apply for a different L-Code and they are not doing
it. Perhaps if they hear from more clinicians who threaten to not buy the
products unless they help US get a better reimbursement, then they will
respond.
Citation
“Responses: Suspension sleeves,” Digital Resource Foundation for Orthotics and Prosthetics, accessed December 24, 2024, https://library.drfop.org/items/show/215973.
