Static AFO question
The Kogans
Description
Collection
Title:
Static AFO question
Creator:
The Kogans
Date:
7/23/2002
Text:
I recently summited to medicare for the L-code 4396 (Static AFO), which
seems to correspond in its description of a custom fit orthosis addressing
pressure relief, for a PRAFO/Multi-Podus boot. It was denied because
Medicare found it not medically necessary. Has anyone else run into this
problem and if so what have you done about it.
In addition, Medicare states that it covers A5510 at $33.00 for a custom fit
insert and $33.00 for A5511 for a custom fabricated insert. 1) does anyone
besides me find this absurd? 2) If I bill A5510 (RT) and A5511(LT), Medicare
denies the A5510 code. Has anyone else found this happening as well?
-Mike Kogan, CP
seems to correspond in its description of a custom fit orthosis addressing
pressure relief, for a PRAFO/Multi-Podus boot. It was denied because
Medicare found it not medically necessary. Has anyone else run into this
problem and if so what have you done about it.
In addition, Medicare states that it covers A5510 at $33.00 for a custom fit
insert and $33.00 for A5511 for a custom fabricated insert. 1) does anyone
besides me find this absurd? 2) If I bill A5510 (RT) and A5511(LT), Medicare
denies the A5510 code. Has anyone else found this happening as well?
-Mike Kogan, CP
Citation
The Kogans, “Static AFO question,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/219351.
