US billing issue: Townsend OA Knee orthosis and Medicare Payment

US billing issue: Townsend OA Knee orthosis and Medicare Payment

Paul Prusakowski

6/11/2008

Dear listmembers,

 

People in my office are going a bit nuts right now due to a situation
regarding billing for an OA knee brace that we had custom fabricated by
Townsend. The device fits great and is taking care of the lady's problem,
but CMS has sent us multiple denials due to Invalid Diagnosis.

 

We have used 715.6 - (osteoarthritis of knee) as well as 715.9
(Osteoarthritis) and been denied twice already.

Calling primary care physician has been a dead end, so it is our job to
figure this one out. Is there a more appropriate code with 2 numbers past
the decimal point?

 

I really appreciate any help or suggestions that you can provide.

 

Thanks,

 

Paul P.

 

 

 

Paul E. Prusakowski, CPO, LPO, FAAOP

Gainesville Prosthetics

6800 NW 9th Blvd, Suite 3

Gainesville, FL 32605

352-331-4221

(fax) 352-332-8074

 

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