split codes and private insurance
Porter, Joseph E.
Description
Collection
Title:
split codes and private insurance
Creator:
Porter, Joseph E.
Date:
11/25/2014
Text:
I am curious how people are handling OTS split codes when it comes to billing private payers such as BCBS, Aetna, UHC, etc. Our experience has been that sometimes they don't allow the code or often require authorization. For example we were told by one insurance company that L4361 requires auth. We pointed out that it is the same device as L4360 just without adjustments and that doesn't require auth but were told that L4361 was not on their list of immediate need codes. Are people billing the split OTS codes to private payers or are you continuing to use the traditional codes? Maybe I'm wrong but I can't see undertaking the administrative burden to get some of these device authorized when the same device with a different code doesn't require auth. Please advise.
Thanks in advance!
Joe
Joseph E. Porter, CO, PTA
Orthotic Department Supervisor
Orthopaedic & Sports Medicine Center
Phone: 410-267-5578 Fax: 410-268-0986
www.osmc.net< <URL Redacted>>
Confidential Communication: The information transmitted via this e-mail is intended only for the person or entity to which it is addressed and may contain confidential and/or proprietary information. Any use, review, retransmission, dissemination or other use of, or pursuing of any action in reliance upon this information by persons or entities other than the intended recipient is strictly prohibited. If you are the recipient of this e-mail transmission in error, please reply to the sender and delete the material from any computer. Thank you.
Thanks in advance!
Joe
Joseph E. Porter, CO, PTA
Orthotic Department Supervisor
Orthopaedic & Sports Medicine Center
Phone: 410-267-5578 Fax: 410-268-0986
www.osmc.net< <URL Redacted>>
Confidential Communication: The information transmitted via this e-mail is intended only for the person or entity to which it is addressed and may contain confidential and/or proprietary information. Any use, review, retransmission, dissemination or other use of, or pursuing of any action in reliance upon this information by persons or entities other than the intended recipient is strictly prohibited. If you are the recipient of this e-mail transmission in error, please reply to the sender and delete the material from any computer. Thank you.
Citation
Porter, Joseph E., “split codes and private insurance,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/236903.