fun with coding responses-2

fun with coding responses-2

Troy Fink, CO

The rest of the responses:
==================

Your brace would code out as following:



                  L1970 Articulated AFO X1 unit

                  L2200 Limited ankle motion modification X1 unit(not a
joint)

                  L2275 Varus/valgus padded modification X1 unit



You cannot itemize for the toe pad or the straps as there are no codes to
describe them and they are considered as part of the original orthosis. Thanks.
========================================
1 L1970

2 L2220



That is all I ever code for this orthosis and we a do a lot of these.
====================================
Here is how I would code this.



L 1970

L 2200

L 2270

L 2820



Quanity of 1(one) on each item. There are some items that you should not

code because they are just part of the fitting process and other coding like

L 2999 would be padding the bill and hard to justify. I wonder what AOPA's

coding people would do since they really don't have to stand behind their

suggestions to the government.
=========================================
L1970 afo

L2220 x 2 dorsi stop

L2270 dorsum strap

L2275 supra malleolar pad

L2770 x 2 Stainless steel per joint

L2999 hallux pad
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L1970(1)

L2210(1)

L2275(1)

L1970...Articulated AFO.............................2 ea. (L/R)

L2200...Lmtd ankle motion (strap)...............2 ea. (L/R)

L2270...V/V cntrl strap, padded..................2 ea. (L/R)

L2275...V/V cntrl mods, padded.................2 ea. (L/R) *



* I have not billed per each modification, i.e. pads, tabs, wedges,

etc., just that those mods are included in each AFO to achieve this

control. I see this as the only point of debate, charging for each

modification. Since the CMS language does not say, each, I have

refrained from doing this.



One more thing, I don't see how we can charge extra for the calf strap

as the CMS language / illustration shows it as inclusive.
===========================================
1-L1970

1-L2200

1-L2275
===============================
I do review of coding for Blue Cross of California. The codes that I would
approve for this AFO are:



L1970 Lt X 1

L2270 Lt X 1

L2770 Lt X 2

L2220 Lt X 1



From a professional standpoint, I would recommend some different footplate
modification, similar to the Oregon Orthotic System technique, which would be
covered under the L2275 code.



Hope this helps.
===========================================
Hi



L 1970x1

L 2200x1

L 2275x1

L 2770X2
======================================
I would submit codes that could be justified based on the function they were
providing:



L1970 X 1 Articulating AFO Base Code

L2200 X 2 Limited Motion of 2 Joints Posterior Strap

L2275 X 1 Varus/Valgus Correction Medial S.M. Trim

L2360 X 1 Extended Footplate Extended F.P.

L2820 X 1 Soft Interface Sections (BK) Soft Interface

                                                                     Pads
======================================
I would code the example as follows:



1 - L1970 - Articulated AFO

1 - L2200 - Limited Motion (posterior limiter strap)

1 - L2270 - Valgus Correction Strap

1 - L2275 - Valgus Correction Feature (plastic modification and pad)

1 - L2999 - Full Length Foot Plate

1 - L2999 - External Heel Post

1 - L2999 - Internal Forefoot Post



I look forward to the consensus of your responses!
===================================
I would say that sometimes a brace can be built to accomodate many problems
that a patient may have and still qualify as more than what you have here.I
admit you are slightly limited with the coding and expect a low price.There are
some small changes that you could make that would elevate the coding and still
provide an excellent product for the patient.If you would like any of these
suggestions please contact me.Here are the codes as follows:

L1970 AFO with joints custom

L2200 Limited motion(the posterior strap allows for limited ROM)

L2275 Varus /Valgus correctional forces,plastic mod,lined

L2270 T strap for strapping at malleolus.Only use this code if you are
controlling a force not just as a skate strap.

L2820 BK innerface.Literally this exists on your brace but,it is up to your
discretion to code for this.

That's about it for this AFO.Hope this helps.
==========================================
I would use 1-L1970 for the AFO.

Having an Rx to go along w/ the photos would be helpful.

 =====================================

Here's my take:



With Inversion/Eversion control



1x L1970



2x L2200



1x L2270



1x L2275



Regards,
==============================================
I will be eager to see the responses. L1970 hinged AFO, L 2275 varus/valgus
correction, and L2820 padding below knee section..All one of each. I have
never tried to bill anything extra for that posterior strap but my guess is that
is what you want to get reimbused for.
================================
AFO as described:

L 1970 custom molded articulating AFO

L2200 Limited motion (the plantar and dorsi stops incorporated)

L2770 x 2 stainless steel ankle joints

L2275 valgus control



That is how I would code the AFO
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 that's all folks!