Region C coding...again
Gary Lamb
Description
Collection
Title:
Region C coding...again
Creator:
Gary Lamb
Date:
8/2/2005
Text:
Dear List,
Apologies to our international friends for this coding string.
Latest in Medicare region C's say what!? column.
Pt was in with a RX for an AFO, 332 pound gentleman, swollen foot and ankle
complex. Impression taken for a custom solid ankle AFO L1960, scheduled for
1 week to be fit. Patient no showed for the appointment, no answer at
home, daily phone calls to follow up all to no avail. Patient calls from
Hospital 180 miles away states they may have to amputate due to infection.
Now two months later...status unknown.
Attempting to file for salvage value of the AFO, Region C informs us the
patient was fit with L2114 (probably a fracture boot from the doctor's
office/stock and bill) a few months earlier and denied the claim as same or
similar device fit with in the preceding five years. So now a patient
fractures an ankle, gets a boot post-op, needs an AFO later and you will be
denied due to same or similar device? Get ready Prosthetists, definitive
limbs are only a thought away in region C if you fit a preparatory.
This is odd since previously we were denied a custom AFO for not trying an
off the shelf AFO on another large patient.
Anybody else having this particular problem?
I love my job it's making payroll that drives me nuts!
Gary A. Lamb LPO, CO, FAAOP
Comprehensive Orthotic-Prosthetic Enterprises (C.O.P.E.)
1742 Hickory St.
Abilene, Texas 79601
<Email Address Redacted>
325-672-5015
Apologies to our international friends for this coding string.
Latest in Medicare region C's say what!? column.
Pt was in with a RX for an AFO, 332 pound gentleman, swollen foot and ankle
complex. Impression taken for a custom solid ankle AFO L1960, scheduled for
1 week to be fit. Patient no showed for the appointment, no answer at
home, daily phone calls to follow up all to no avail. Patient calls from
Hospital 180 miles away states they may have to amputate due to infection.
Now two months later...status unknown.
Attempting to file for salvage value of the AFO, Region C informs us the
patient was fit with L2114 (probably a fracture boot from the doctor's
office/stock and bill) a few months earlier and denied the claim as same or
similar device fit with in the preceding five years. So now a patient
fractures an ankle, gets a boot post-op, needs an AFO later and you will be
denied due to same or similar device? Get ready Prosthetists, definitive
limbs are only a thought away in region C if you fit a preparatory.
This is odd since previously we were denied a custom AFO for not trying an
off the shelf AFO on another large patient.
Anybody else having this particular problem?
I love my job it's making payroll that drives me nuts!
Gary A. Lamb LPO, CO, FAAOP
Comprehensive Orthotic-Prosthetic Enterprises (C.O.P.E.)
1742 Hickory St.
Abilene, Texas 79601
<Email Address Redacted>
325-672-5015
Citation
Gary Lamb, “Region C coding...again,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 25, 2024, https://library.drfop.org/items/show/225301.
