Medicare base code vs add on codes
karl W entenmann
Description
Collection
Title:
Medicare base code vs add on codes
Creator:
karl W entenmann
Date:
5/26/2004
Text:
To my esteemed colleagues,
I was recently asked by our local Medicaid Authorization supervisor a
question regarding BK or AK prosthesis base codes that describe a
prosthesis with a SACH foot and how we bill for a different foot (such as
energy storing foot) when the SACH foot is not used. The question was
why the payment for the base code is not reduced if we don't use the SACH
foot. I explained that the base code describes the basic prosthesis and
when a different foot or other component is used the payment for that
foot takes into account the amount for the SACH foot, and that it really
does not accurately describe the cost of the add on foot but the
difference between it and the base code foot. I was asked if there was
anything in writing to describe this and I have not been able to find it
in the Medicare Manual. Does anyone on the list know where that
information may be hiding? She wants to explain this to her staff and
have back up in case of an audit. Thanks.
Karl Entenmann, CPO
Preferred O and P
Federal Way, WA
________________________________________________________________
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I was recently asked by our local Medicaid Authorization supervisor a
question regarding BK or AK prosthesis base codes that describe a
prosthesis with a SACH foot and how we bill for a different foot (such as
energy storing foot) when the SACH foot is not used. The question was
why the payment for the base code is not reduced if we don't use the SACH
foot. I explained that the base code describes the basic prosthesis and
when a different foot or other component is used the payment for that
foot takes into account the amount for the SACH foot, and that it really
does not accurately describe the cost of the add on foot but the
difference between it and the base code foot. I was asked if there was
anything in writing to describe this and I have not been able to find it
in the Medicare Manual. Does anyone on the list know where that
information may be hiding? She wants to explain this to her staff and
have back up in case of an audit. Thanks.
Karl Entenmann, CPO
Preferred O and P
Federal Way, WA
________________________________________________________________
The best thing to hit the Internet in years - Juno SpeedBand!
Surf the Web up to FIVE TIMES FASTER!
Only $14.95/ month - visit www.juno.com to sign up today!
Citation
karl W entenmann, “Medicare base code vs add on codes,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 6, 2024, https://library.drfop.org/items/show/223065.
