USA subject - proper coding for bilateral hip abduction orthosis

USA subject - proper coding for bilateral hip abduction orthosis

8/12/2008

Dear Colleagues:
 
An orthotic customer has asked for my advice on the coding of a bilateral
HippO(TM) hip abduction orthosis. Being as I am a CPO whose company
manufacturers the orthosis, I should know the answer to this question, but I
am ashamed to say I don't.
 
I'm inclined to think this orthotist should bill for the complete HippO, but
instead of 1 joint specify 2 (using the bilateral modifier) and for the
second thigh cuff she should use the miscellaneous code, L2999. But I'm not
sure. Is there a better solution for the second thigh cuff? Can she bill for
two unilateral hip orthoses? That would seem to not be right, as they would
be sharing one pelvic component. Also, quite frankly, I don't find the
miscellaneous codes in my CMS alphanumeric codes Excel file? Are they no
longer used?
 
Thanks, in advance, for the assistance.
 
David
 
 
David Hendricks, CPO, FAAOP
<Email Address Redacted>
HOPE Orthopedic
Orlando, FL
407-850-0411
fax: 407-851-8922
 < <URL Redacted>> www.hopeortho.com