L5420
John T. Brinkmann
Description
Collection
Title:
L5420
Creator:
John T. Brinkmann
Date:
7/9/2004
Text:
List Members,
Original Question:
I was just told that L5420 is automatically denied by our DMERC as a non-covered item. Is this the usual experience? I provided a plastic post-op system (Flo-Tech) a week after surgery (when patient was out of the hospital).
John Brinkmann, CPO
Answer: This code is only covered for patients in the hospital immediately after surgery. Here is a response from a manufacturer of plastic post-op systems:
Rejections of this type are fairly routine, if you provide the service after discharge. You should bill it as a preparatory L5585 + L5460 plus components, alignable system, etc. You will be able to provide a custom preparatory prosthesis after 90 days.
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Original Question:
I was just told that L5420 is automatically denied by our DMERC as a non-covered item. Is this the usual experience? I provided a plastic post-op system (Flo-Tech) a week after surgery (when patient was out of the hospital).
John Brinkmann, CPO
Answer: This code is only covered for patients in the hospital immediately after surgery. Here is a response from a manufacturer of plastic post-op systems:
Rejections of this type are fairly routine, if you provide the service after discharge. You should bill it as a preparatory L5585 + L5460 plus components, alignable system, etc. You will be able to provide a custom preparatory prosthesis after 90 days.
---------------------------------
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Citation
John T. Brinkmann, “L5420,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 6, 2024, https://library.drfop.org/items/show/223380.
