Re: partial finger prosthesis
Adam Canvisser
Description
Collection
Title:
Re: partial finger prosthesis
Creator:
Adam Canvisser
Date:
6/30/2011
Text:
________________________________
From: Adam Canvisser
Sent: Thursday, June 30, 2011 8:57 AM
To: <Email Address Redacted>
Cc: Adam Canvisser
Subject: partial finger prosthesis
Dear colleagues, Thank you for all that responded to my post re: code for partial finger. The responses: One response suggested using L6900's codes which unfortunately would not even cover the fabrication costs. One response wrote that L7499 is a valid medicare code and gave website www.dmepdac.com< <URL Redacted>> to verify. I agree this is a valid medicare code but bc/bs will not accept any code without a fee schedule. Two other responses were to use L6000 and L6905. These codes do not follow description of a partial finger and reimbursement again would not even cover fabrication costs. In summary many prosthetists are getting paid generously using the L7499 code for workers comp and medicare but not for BC/BS. My case is now under review with a special case manager at BC/BS and they said that they will except that code but will not let us know what they will reimburse until we submit our claim.We will need to see if patient is willing to sign a form stating they are responsible if BC/BS does not pay the amount billed. Thanks again for all responses. Sincerely Adam Canvisser CPO
From: Adam Canvisser
Sent: Thursday, June 30, 2011 8:57 AM
To: <Email Address Redacted>
Cc: Adam Canvisser
Subject: partial finger prosthesis
Dear colleagues, Thank you for all that responded to my post re: code for partial finger. The responses: One response suggested using L6900's codes which unfortunately would not even cover the fabrication costs. One response wrote that L7499 is a valid medicare code and gave website www.dmepdac.com< <URL Redacted>> to verify. I agree this is a valid medicare code but bc/bs will not accept any code without a fee schedule. Two other responses were to use L6000 and L6905. These codes do not follow description of a partial finger and reimbursement again would not even cover fabrication costs. In summary many prosthetists are getting paid generously using the L7499 code for workers comp and medicare but not for BC/BS. My case is now under review with a special case manager at BC/BS and they said that they will except that code but will not let us know what they will reimburse until we submit our claim.We will need to see if patient is willing to sign a form stating they are responsible if BC/BS does not pay the amount billed. Thanks again for all responses. Sincerely Adam Canvisser CPO
Citation
Adam Canvisser, “Re: partial finger prosthesis,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 23, 2024, https://library.drfop.org/items/show/232704.
