Stance control KAFO procedure code RESPONSES

Randy McFarland

Description

Title:

Stance control KAFO procedure code RESPONSES

Creator:

Randy McFarland

Date:

4/2/2013

Text:

ORIGINAL POST
It appears that L2005 stance control KAFO is a base code. Does that prevent
me from billing for a full plastic KAFO L2036 which is also a base code?
 Randy McFarland,CPO Fullerton, CA

Note: I didn't find much about this L2005 Code on OPIE search engine, but I
suspect that the last response summarizes things, at least for Medicare
patients.

RESPONSES

You can bill for only one base code so yes that is correct.

You will be denied as providing same or similar within life expectancy for
Medicare and Medicaid. Do not know how this would be addressed by private
insurance. Good luck.

Yes. Yes it does!

yes it does....bill l2005 and then your add ons. be careful with
Medicare......they've grouped all the stance controls under l 2005, so an
rang would reimburse the same as a full stride through Medicare.

At the same time, LOL that would be not be good. Both are base codes.

Can't combine base codes on same device. But can add plastic uppers and
lowers to the base code.

You can only bill L 2005

The L2005 isn't a base code, it's a bundled code and includes everything no
matter which system you use and no matter if its metal & leather, plastic &
metal or laminated.





 

                          

Citation

Randy McFarland, “Stance control KAFO procedure code RESPONSES,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 24, 2024, https://library.drfop.org/items/show/235042.