Re: L-coding

Kathy Dodson

Description

Title:

Re: L-coding

Creator:

Kathy Dodson

Date:

10/12/2007

Text:

Hi Jeff,

Since the response to you questions may be helpful to others, I've taken
the liberty of copying the listserv to save you the trouble of reposting
my response.

 

AOPA shares your concern with questionable coding and the possible
consequences from Medicare or private insurers. Because of our strong
desire to help facilities code correctly, we do make recommendations for
the coding of specific devices. If an AOPA member asks for coding
assistance on a particular device, whether it be a prefabricated or
custom device, we will give them AOPA's recommended coding. This is
developed by a standing AOPA committee, the Coding and Reimbursement
Committee (CRC), made up of certified practitioners. These
recommendations are then also included in the following product.

 

We have just introduced an exciting new web-based product,
LCodeSearch.com, that is currently free to AOPA member facilities, where
you can look up devices to see the AOPA coding recommendations. In
addition to information entered by AOPA, this database is constantly
being updated by manufacturers. However before any product coding
recommendations go live on the site, they are reviewed by AOPA to ensure
that we agree. AOPA also adds to this database the mandatory coding
decisions put out by the SADMERC. As time goes by and this database
grows, it will become the primary AOPA resource for device coding
information.

 

We also include coding recommendations in all of our Coding & Billing
Seminars, in addition to periodically addressing coding questions in the
AOPA In Advance newsletter that all AOPA members should be receiving, as
well as in the O&P Almanac. (If you are a member and are not receiving
the AIA, please contact Corrin Mullins in our membership department at
<Email Address Redacted> )

 

Of course, we also have staff that is happy to respond to member's
questions regarding how to code devices. If we cannot immediately
respond to your question, we will check with the CRC and get back to you
shortly with our recommendation. You can contact Joe McTernan at
<Email Address Redacted> or me at <Email Address Redacted>

 

As to interaction with manufacturers, we welcome the opportunity to work
with manufacturers at any point in the process of product development
and code application, to provide information on how the coding system
works, some of the common pitfalls to code applications and how some
marketing decisions, for example the name of a device, can impact later
coding and coverage decisions by Medicare.

 

In addition, when we become aware of manufacturers' coding
recommendations that we feel are inappropriate, we notify that
manufacturer of our concern and provide it with our recommended codes.
However, for both manufacturer and patient care facility members, the
final decision on how to code a device remains with that entity. AOPA
does not have the authority to compel the use of our recommendations.
Our hope is that all parties will recognize the threat that incorrect
coding represents to the profession and ultimately to your patients and
will refrain from putting us all in jeopardy.

 

Jeff, thanks for the opportunity to make many people aware of AOPA's
coding activities. If you have any other questions, please feel free to
contact me.

 

Kathy Dodson

Senior Director of Government Affairs

AOPA

571 431-0810

<Email Address Redacted>

 

-----Original Message-----
From: Orthotics and Prosthetics List [mailto:<Email Address Redacted>] On
Behalf Of Jeff Hoerner
Sent: Thursday, October 11, 2007 1:38 PM
To: <Email Address Redacted>
Subject: [OANDP-L] L-coding

 

If this is being done I apologize and if you can add your thoughts,
please

feel free. I will publish the responses.

 

 

 

Does APOA maintain a data base or take an official stance on a
particular

product or service and what L-codes are appropriate and which are not.
With

the shrinking of L-codes and verbiage of with or without it seems we

should do a better job of policing ourselves or Medicare will do the job
for

us. When I see a ad for a 5-code brace or the use of L2275 on every
type

of plastic AFO, in the short term I see profit, but I also see the
Federal

government taking a stand and paring the L-coding even further. Then

everyone including patients loses.

 

 

 

Do products ever go before a committee of APOA representatives to
receive a

blessing so to speak on what is appropriate and what isn't regarding

L-coding. With AOPA's input from the beginning of a products L-coding

status, AOPA would receive less phone calls from companies regarding
this

issue, plus be in a better position to stand up for how and why certain

items are coded certain ways.

 

 

 

Just a thought, I'd like to hear yours.

 

 

 

 

 

 

 

Lifestyle P&O

 

Jeff Hoerner CPO

 

27 Charles Street

 

North Andover, MA 01845

 

tel:978-688-7900

 

fax: 978-688-7938

 

 

 

 

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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

Kathy Dodson, “Re: L-coding,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/228665.