Responces - Socket replacement

Description

Title:

Responces - Socket replacement

Text:

As per protocol on the OANDP List I am posting responses to the question
asked.

Original question: I am aware of facilities that always bill L5910 with
L5700 and L5920 with L5701. Are they wrong in billing L5910 or L5920 for the
attachment plate on replacement sockets?

Al Pike, CP……..

Given the few replies to the question it would appear that the answer is not
that clear.

The consensus of those that did respond would be that automatically billing
L5910 or 5920 with L5700 or 5701 is wrong.

Interpretation of AOPA's interpretation could lead one to believe you could
stretch it a little to include only the attachment plate when billed with
L5700 or L5710. The interpretation is vague enough to go both ways.

An addition to an endoskeletal trans-tibial (BK) prosthesis, units that fit
between the socket and the foot and are capable of changing the alignment of
the prosthesis.

An addition to an endoskeletal trans-femoral (AK), knee or hip
disarticulation prosthesis, units that fit between the socket and the foot,
less the knee, and are capable of changing the alignment of the prosthesis.

************

I've always assumed that the alignable system code referred to the whole
system, not just one component. I'm interested in hearing the consensus of
the respondents.

********

It only makes sense to not charge for something that was already charged for
previously. Unless the components are worn out or look defective. I just try
to do the right thing even if it means less money. It's easier to sleep at
night that way.

Citation

“Responces - Socket replacement,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 6, 2024, https://library.drfop.org/items/show/217394.