Repair old prosthesis AND start new prosthesis...coding ?
Paul Prusakowski
Description
Collection
Title:
Repair old prosthesis AND start new prosthesis...coding ?
Creator:
Paul Prusakowski
Date:
1/4/2012
Text:
Happy New Year everyone,
I am working with a new patient who recently moved down from the frozen
northern part of the country. The patient wears an old exoskeletal
prosthesis that he has been wearing for about 10 years, but the foot is
basically destroyed and is in need of replacement. The patient has a Rx for
replacement of foot as well as a Rx for a new prosthesis because the old
prosthesis, although functional, has seen much better days and has been well
worn.
Replacing the foot is a no brainer, but since I will be starting work on a
new prosthesis soon, I want to make sure that I code appropriately so that I
do not end up creating an issue for myself down the line.
The patient has Medicare as insurance.
My initial thoughts are using L7510 (Repair of Prosthetic Device, Repair or
Replace Minor Parts) and L7520 (Repair Prosthetic Device, Labor Component,
per 15 minutes) for the work I am doing right now. But, I question this
due to L7510 stating that it is for 'minor' parts, and the Truestep
Exoskeletal foot is not something I would consider something minor such as a
strap, buckle, etc..
The entire foot is being replaced, so I don't actually think that using
L5979 is that far off base either, but I am concerned that if I use that
code that there will be an issue when I provide the patient with an entirely
new prosthesis in a month or two, most likely using the same code because
this is the preferred foot.
Any suggestions on how to go about this appropriately and cleanly ?
Paul E. Prusakowski, CPO, FAAOP
Gainesville Prosthetics
I am working with a new patient who recently moved down from the frozen
northern part of the country. The patient wears an old exoskeletal
prosthesis that he has been wearing for about 10 years, but the foot is
basically destroyed and is in need of replacement. The patient has a Rx for
replacement of foot as well as a Rx for a new prosthesis because the old
prosthesis, although functional, has seen much better days and has been well
worn.
Replacing the foot is a no brainer, but since I will be starting work on a
new prosthesis soon, I want to make sure that I code appropriately so that I
do not end up creating an issue for myself down the line.
The patient has Medicare as insurance.
My initial thoughts are using L7510 (Repair of Prosthetic Device, Repair or
Replace Minor Parts) and L7520 (Repair Prosthetic Device, Labor Component,
per 15 minutes) for the work I am doing right now. But, I question this
due to L7510 stating that it is for 'minor' parts, and the Truestep
Exoskeletal foot is not something I would consider something minor such as a
strap, buckle, etc..
The entire foot is being replaced, so I don't actually think that using
L5979 is that far off base either, but I am concerned that if I use that
code that there will be an issue when I provide the patient with an entirely
new prosthesis in a month or two, most likely using the same code because
this is the preferred foot.
Any suggestions on how to go about this appropriately and cleanly ?
Paul E. Prusakowski, CPO, FAAOP
Gainesville Prosthetics
Citation
Paul Prusakowski, “Repair old prosthesis AND start new prosthesis...coding ?,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/233298.
