Billing question: SANDMEC approval
Frank Frankovitch
Description
Collection
Title:
Billing question: SANDMEC approval
Creator:
Frank Frankovitch
Date:
3/7/2007
Text:
It is my understanding that with exception of traditional DME items
(wheelchairs, walkers, Oxygen, etc.) and Diabetic Shoes, Medicare DOES NOT
require SANDMERC approval for manufacturer's pre-fabricated orthotic and
prosthetic devices (wrist splints, knee orthoses, pre-fab TLSO/LSO's). They
do state some of these items must be submitted for approval before they will
provide coding verification but these items are specifically EXCLUDED from
a list of items they state MUST have SANDMERC coding approval before they
can be billed. Wondering if this is correct and if anyone has experience or
knows of instances in which Medicare took back moneys for items (other than
DME or diabetic shoes) billed which were not SANDMERC approved. Thanks in
advance.
Frank Frankovitch, CPO, FAAOP
PENN Prosthetics & Orthotics
(wheelchairs, walkers, Oxygen, etc.) and Diabetic Shoes, Medicare DOES NOT
require SANDMERC approval for manufacturer's pre-fabricated orthotic and
prosthetic devices (wrist splints, knee orthoses, pre-fab TLSO/LSO's). They
do state some of these items must be submitted for approval before they will
provide coding verification but these items are specifically EXCLUDED from
a list of items they state MUST have SANDMERC coding approval before they
can be billed. Wondering if this is correct and if anyone has experience or
knows of instances in which Medicare took back moneys for items (other than
DME or diabetic shoes) billed which were not SANDMERC approved. Thanks in
advance.
Frank Frankovitch, CPO, FAAOP
PENN Prosthetics & Orthotics
Citation
Frank Frankovitch, “Billing question: SANDMEC approval,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/227946.
