Chrome/nickle replies

Chrome/nickle replies

Following are the replies received. The original question is at the bottom
of the list.
Also, a few more questions and my suggestion for revising these codes follows
via a separate reply.

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Powder coating is the equivalent as is anodizing.

+++++

Medicare has neither the time nor interest in recognizing any coding
practice. If you insist and submit your question to the SADMERC they will
issue a ruling.....eventually. corrosion resistant surface is about as
gereric as it can be, and that is the way the SADMERC wants the codes. Any
item that is functionally equivalent should be billed under an existing
code. They do want the codes to be precise or specific as that would make
it more difficult to bill properly using an existing code. And the last
thing they want to do is issue a new code.

+++++

There are several KAFO components still available from Otto Bock that
require plating. You're right it is not a generally used code, but I'll
guarantte that if you change the verbage to a more generalized form, there
will be a stampede to use the code for every thing from clear acrylic spray
to plastic laminate.

+++++

At AOPA Coding seminars L2750 and L2780 have been discussed, and the
concensus was that specialized coatings other than chrome/nickel should use
L2780.

I agree with you that plating has been made virtually obsolete by the newer
materials and welding techniques. Plastisol dipping, powder coating, and
other processes offer a great way to protect uprights against corrosion from
urine and high acidity perspiration.

It can't hurt to keep L2750 (chrome/nickel plating) on the list even though
most of us (I think) use L2780.

+++++

Your post is very interesting. And very multi-faceted one as well. Let me
start by saying that, as a manufacturer, I'm not terribly familiar with the
L-Coding system in regards as to what to use and when. But, I can tell you
about the processes.

I am not aware of anyone who goes through the trouble of nickle or chrome
plating their work (except in rare circumstances) and there would be no
point in a manufacturer in offering plated uprights because the plating
would just chip off when you bent them. Even when using aluminum, you can
achieve a mirror finish with copious amounts of rouge and a buffing wheel
without having to go through the trouble or expense of plating.

As far as other coatings go, an excellent alternative is powdercoating. It
is as strong as plating and does as good a job of preventing rust. It is
very cheap, easy to apply and comes in any color and a variety of textures.
It seems to me that the L-Codes to which you allude can be applied to this
process as well.

+++++

It should first be asked if the technique is medically necessary.

Some instances when use of these codes might be appropriate would be when 1)
a persons perspiration causes the material to breakdown, the working climate
caused the material to breakdown(a caustic environment) or a problem with
urination. In these cases , the result might be a skin irritation from the
degraded material.

If the finish is cosmetic it would not be covered by Medicare, however if
the patient wanted it they could pay and you could ZY it, as a non-covered
service.

Because I believe each of these codes is mutually exclusive they would not
be used together. If you take a stainless bar it does not corrode, therefore
it would be redundant to add non-corrosive to the L2770 coded item. Likewise
titanium or plated items.

+++++

You are showing your age! Why not follow up with how to forge joints or data
acquisition in P&O using CT or MRI scanning?

=========================================
Original Question

Dear Colleagues and Guests,

I am wondering how many practitioners use chrome or nickle plating codes in
the course of offering orthotic services and in what circumstances. This
used to be a very popular and necessary process to help prevent rust on
cold-rolled or hot-rolled steel components. There were other rust-inhibiting
processes used too, like fish-oil finishing, etc. With today's technology
and materials, I am trying to think where nickle or chrome plating might be
used and am having a hard time trying to visualize a circumstance where I
might use this process today. I have even more difficulty trying to validate
this as a cost effective procedure, given the cost of having parts plated,
versus using stainless steel and modern welding techniques. Am I looking at
this from the wrong angle? Are these codes still hanging around for
occasional usage where plating might still used by some in the field? Or,
are these codes for use to designate rust-prone sidebars that are already
plated? If that is the case, who manufactures plated sidebars?

Even if plating is still a valid procedure, it seems that this LCode would
better serve the profession if it were renamed to signify long term and long
wearing corrosion resistant coatings that are applied for either
rust-proofing or as an anti-oxidation process. This would include other
materials, such as aluminum or titanium, in addition to the rust-prone
materials. Any thoughts about this?

Also, to muddy the waters a bit more, I see the other non-corrosive finish
code, (per bar) as a sandblasted or abrasive brush finish with an acrylic
spray or dip coating that is designed to retard oxidation, not necessarily
prevent it on a long term basis.

Any agreement or disagreement? Thanks for any replies. I'll post replies
without reference to indiviuduals who respond.

Wil Haines, CPO