Code A5511

Karla Shay Office Manager

Description

Title:

Code A5511

Creator:

Karla Shay Office Manager

Text:

Medicare just processed our first claim for A5511. They allowed only $33
each for these for diabetics, custom molded from model of patient's foot,
multiple density inserts, custom fabricated.

Medicare tells me verbally, though it is not written policy, that 3 pair are
allowed per year if the patient also gets shoes coded A5500.

Also - A5510 is not a covered code.

We are in region D.

I am interested in knowing if others are getting paid more for A5511. We are
disappointed at such low reimbursement for custom inserts.

Any ideas on how to get the allowable increased?

KarlShay

                          

Citation

Karla Shay Office Manager, “Code A5511,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 6, 2024, https://library.drfop.org/items/show/218037.