Billing question: Partial Calcaneus
Paul E. Prusakowski
Description
Collection
Title:
Billing question: Partial Calcaneus
Creator:
Paul E. Prusakowski
Date:
2/25/2002
Text:
Hello,
I have a billing question that I am hoping someone may be able to help on.
Some of you may recall the partial calcaneus challenge that I had requested
help on a few months ago. After struggling in-house with attempting to
fabricate UCBL-type orthoses with gel inlay, I finally sent a new impression
to the Riekens folks and had a custom PQ-gel insert fabricated that
incorporated a very thick heel filler/cushion which seemed to solve he
problem for the individual.
Now, my problem is properly coding for the device and finding an appropriate
diagnosis code. First of all, I cannot seem to find an ICD-9 code for
partial calcaneus... Calling the physician's office results in diagnosis
codes that are far from applicable....go figure.
Second, is appropriate coding for the prosthosis. It's basically a thick
gel shoe insert, but the it cost much more than any other insert I have ever
made. It seems to be another one of those situations where the codes we
have to work with don't really apply that well. Any suggestions based upon
past experiences? Also, keeping in mind the 2 failed attempts at
fabricating an appropriate device which was never acceptable to the patient.
Did I just eat a big lunch?
Paul Prusakowski, CPO
O&P Clinical Technologies
Gainesville, Florida
I have a billing question that I am hoping someone may be able to help on.
Some of you may recall the partial calcaneus challenge that I had requested
help on a few months ago. After struggling in-house with attempting to
fabricate UCBL-type orthoses with gel inlay, I finally sent a new impression
to the Riekens folks and had a custom PQ-gel insert fabricated that
incorporated a very thick heel filler/cushion which seemed to solve he
problem for the individual.
Now, my problem is properly coding for the device and finding an appropriate
diagnosis code. First of all, I cannot seem to find an ICD-9 code for
partial calcaneus... Calling the physician's office results in diagnosis
codes that are far from applicable....go figure.
Second, is appropriate coding for the prosthosis. It's basically a thick
gel shoe insert, but the it cost much more than any other insert I have ever
made. It seems to be another one of those situations where the codes we
have to work with don't really apply that well. Any suggestions based upon
past experiences? Also, keeping in mind the 2 failed attempts at
fabricating an appropriate device which was never acceptable to the patient.
Did I just eat a big lunch?
Paul Prusakowski, CPO
O&P Clinical Technologies
Gainesville, Florida
Citation
Paul E. Prusakowski, “Billing question: Partial Calcaneus,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 4, 2024, https://library.drfop.org/items/show/218024.
