New CMS codes for 2014 and Discussion
Steve Lusky
Description
Collection
Title:
New CMS codes for 2014 and Discussion
Creator:
Steve Lusky
Date:
1/6/2014
Text:
All,
I have had an extensive conversation with CMS regarding the new codes and it was very enlightening. The conversation is too detailed to completely post. I have highlighted below the key areas of discussion.
My conversation ranged from why the codes were created to application by a person of expertise. Ultimately, it appears these codes were created for the following reasons:
* Created for the purpose to have new codes for competitive bidding
* What is considered a person of expertise
* Why the new codes get the same amount as the old codes
* What about PDAC
They have been trying to do something to stop mail order companies from just shipping these things to patients. This is their attempt. I understand but they should have just changed the process to say that orthotics must be applied and not mailed. They could have saved everyone a lot of hassle. I think they want mail order for the new codes under competitive bidding at a greatly reduced rate, say $200. Unfortunately, the beneficiary will be subject to one brace in five years. Therefore, if they get a brace coded L0642 for $100 from mail order, a normal supplier will not be able to give them a brace coded L0627 because of the five year rule. Feel free to call me on my cell phone at 610-587-1138 if you want to discuss in more detail. Hope this helps.
Steve Lusky
President
XBack Bracing Services
I have had an extensive conversation with CMS regarding the new codes and it was very enlightening. The conversation is too detailed to completely post. I have highlighted below the key areas of discussion.
My conversation ranged from why the codes were created to application by a person of expertise. Ultimately, it appears these codes were created for the following reasons:
* Created for the purpose to have new codes for competitive bidding
* What is considered a person of expertise
* Why the new codes get the same amount as the old codes
* What about PDAC
They have been trying to do something to stop mail order companies from just shipping these things to patients. This is their attempt. I understand but they should have just changed the process to say that orthotics must be applied and not mailed. They could have saved everyone a lot of hassle. I think they want mail order for the new codes under competitive bidding at a greatly reduced rate, say $200. Unfortunately, the beneficiary will be subject to one brace in five years. Therefore, if they get a brace coded L0642 for $100 from mail order, a normal supplier will not be able to give them a brace coded L0627 because of the five year rule. Feel free to call me on my cell phone at 610-587-1138 if you want to discuss in more detail. Hope this helps.
Steve Lusky
President
XBack Bracing Services
Citation
Steve Lusky, “New CMS codes for 2014 and Discussion,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/235968.
