Prosthetic Exclusion Query Results

Prosthetic Exclusion Query Results

Jim Thelen

11/9/2011

Thanks to all those who responded to my question about prosthetic snf
exclusions that may be billed to Medicare Part B for a Part A bed patient.
The results are below.

I received excel files from several practitioners and here is the link for
your use:
<URL Redacted>.
Prosthetics begins at line 364. I also got a more thorough answer from
Brett Saunders with a great explanation:

For patients in their part A stay...in the first 100 days in a SNF .... All
prosthetics are billable directly to your regional DMAC EXCEPT for textile
items - socks/shrinker and postop/preparatory prosthetics. [Comment: I do
see Preparatory Prostheses on the exclusions list]

After the first 100 days, all prosthetics and orthotics can be billed
directly to your regional DMAC

Thanks again.

Jim Thelen, CP, BOCO, LPO

Trinidad Medical Consultants

Dallas, TX

214-340-6200

Fax 214-340-2206