Fwd: [OANDP-L] CPT codes
Sprague Hanavan CO
Description
Collection
Title:
Fwd: [OANDP-L] CPT codes
Creator:
Sprague Hanavan CO
Date:
2/22/2006
Text:
-----Original Message-----
From: Warren Mays < <Email Address Redacted> >
To: <Email Address Redacted>
Sent: Wed, 22 Feb 2006 16:36:20 -0800
Subject: RE: [OANDP-L] CPT codes
For those who may not receive Advance in directors in Rehabilitation, I will
paraphrase from the article written by Rick Gawenda, PT, director of
physical medicine and rehabilitation at Detroit Receiving Hospital in
Michigan.
The change in description for 97760 was due to the fact that suppliers and
providers had no mechanism to report the assessment and management of a
patient using an orthotic. According to CPT Changes 2006: An Insider's View,
orthotic management includes assessing the patient; determining the most
appropriate orthotic; and designing, selecting and fabricating the
orthotic.
This is good news for suppliers and providers who weren't using and billing
L codes to Medicare contractors for Part B therapy services for
prefabricated or custom orthoses. Previously under code 97504, fabrication
time wasn't supposed to be included when determining how many units of 97504
to bill. Fabrication time, along with assessment, fitting and supplies was
reimbursed by billing the L codes.
For private practitioners, you needed a durable medical equipment (DME)
license in order to bill L codes to a DME regional carrier. Hospital
outpatient departments, SNF Part B, CORFs and rehab agencies could bill
Medicare fiscal intermediaries on the UB-92 claim without a DME license.
In addition, many non-Medicare payers required all settings to have a DME
license to bill for prefabricated or custom orthoses, or they simply didn't
reimburse suppliers or providers of these devices if they were provided by a
physical or occupational therapist.
With the new code and description, private practitioners can now bill a
Medicare carrier for the assessment, fabrication and fitting of a custom
fabricated orthotic device without a DME license. In addition, suppliers and
providers in all settings can use this new code for non-Medicare payers who
may not have reimbursed for L codes billed under a therapy plan of care.
Maybe our new Orthotic and Prosthetic Alliance can comment on this obvious
increase in the scope of services provided by PT's.
What say you?
Warren Mays, CPO
Original Message-----
From: Orthotics and Prosthetics List [mailto:<Email Address Redacted>] On
Behalf Of Sprague Hanavan CO
Sent: Wednesday, February 22, 2006 2:12 PM
To: <Email Address Redacted>
Subject: [OANDP-L] CPT codes
Has any body else has read the article in the new Advance for Directors in
Rehabilitation magazine Feb 06 on page 14. Can anybody explain to me what
has just been allowed and how this does not effect us as trained
professionals. Just wondering if my chosen profession will be gone before
my student loans are paid off.
Sprague Hanavan CPO
********************
To unsubscribe, send a message to: <Email Address Redacted> with
the words UNSUB OANDP-L in the body of the
message.
If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
Paul E. Prusakowski,CPO at <Email Address Redacted>
OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list. Professional credentials
or affiliations should be used in all communications.
********************
To unsubscribe, send a message to: <Email Address Redacted> with
the words UNSUB OANDP-L in the body of the
message.
If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
Paul E. Prusakowski,CPO at <Email Address Redacted>
OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list. Professional credentials
or affiliations should be used in all communications.
From: Warren Mays < <Email Address Redacted> >
To: <Email Address Redacted>
Sent: Wed, 22 Feb 2006 16:36:20 -0800
Subject: RE: [OANDP-L] CPT codes
For those who may not receive Advance in directors in Rehabilitation, I will
paraphrase from the article written by Rick Gawenda, PT, director of
physical medicine and rehabilitation at Detroit Receiving Hospital in
Michigan.
The change in description for 97760 was due to the fact that suppliers and
providers had no mechanism to report the assessment and management of a
patient using an orthotic. According to CPT Changes 2006: An Insider's View,
orthotic management includes assessing the patient; determining the most
appropriate orthotic; and designing, selecting and fabricating the
orthotic.
This is good news for suppliers and providers who weren't using and billing
L codes to Medicare contractors for Part B therapy services for
prefabricated or custom orthoses. Previously under code 97504, fabrication
time wasn't supposed to be included when determining how many units of 97504
to bill. Fabrication time, along with assessment, fitting and supplies was
reimbursed by billing the L codes.
For private practitioners, you needed a durable medical equipment (DME)
license in order to bill L codes to a DME regional carrier. Hospital
outpatient departments, SNF Part B, CORFs and rehab agencies could bill
Medicare fiscal intermediaries on the UB-92 claim without a DME license.
In addition, many non-Medicare payers required all settings to have a DME
license to bill for prefabricated or custom orthoses, or they simply didn't
reimburse suppliers or providers of these devices if they were provided by a
physical or occupational therapist.
With the new code and description, private practitioners can now bill a
Medicare carrier for the assessment, fabrication and fitting of a custom
fabricated orthotic device without a DME license. In addition, suppliers and
providers in all settings can use this new code for non-Medicare payers who
may not have reimbursed for L codes billed under a therapy plan of care.
Maybe our new Orthotic and Prosthetic Alliance can comment on this obvious
increase in the scope of services provided by PT's.
What say you?
Warren Mays, CPO
Original Message-----
From: Orthotics and Prosthetics List [mailto:<Email Address Redacted>] On
Behalf Of Sprague Hanavan CO
Sent: Wednesday, February 22, 2006 2:12 PM
To: <Email Address Redacted>
Subject: [OANDP-L] CPT codes
Has any body else has read the article in the new Advance for Directors in
Rehabilitation magazine Feb 06 on page 14. Can anybody explain to me what
has just been allowed and how this does not effect us as trained
professionals. Just wondering if my chosen profession will be gone before
my student loans are paid off.
Sprague Hanavan CPO
********************
To unsubscribe, send a message to: <Email Address Redacted> with
the words UNSUB OANDP-L in the body of the
message.
If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
Paul E. Prusakowski,CPO at <Email Address Redacted>
OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list. Professional credentials
or affiliations should be used in all communications.
********************
To unsubscribe, send a message to: <Email Address Redacted> with
the words UNSUB OANDP-L in the body of the
message.
If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
Paul E. Prusakowski,CPO at <Email Address Redacted>
OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list. Professional credentials
or affiliations should be used in all communications.
Citation
Sprague Hanavan CO, “Fwd: [OANDP-L] CPT codes,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 6, 2024, https://library.drfop.org/items/show/226184.
