Medicare Region C replies

Paula Pivko

Description

Title:

Medicare Region C replies

Creator:

Paula Pivko

Date:

10/8/2011

Text:

Here are the basic responses to my question about billing a locking pin system with a suction socket. The majority is saying that no we cannot bill these codes together; Medicare considers it redundant and an overpayment. This applies to both an above knee and below knee suction socket. Whether you can get it approved with proper documentation in case of an audit, as someone mentioned I don't know. I will let you know as we find out.

I have used both a lock and a suction system for activity specific needs. I
> use an expulsion valve and a sealing sleeve to a pin system. I asked this
> question at the APOA coding seminar and they said to make sure you document
> the medical necessity of and additional suspension system. I hope this
> helps.
No you can not bill together. (Just sat in on a webinar.)

Paula Martinek, LPO

 

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Citation

Paula Pivko, “Medicare Region C replies,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 6, 2024, https://library.drfop.org/items/show/233045.