Diagnosis coding vs. design type
Dave Hewett
Description
Collection
Title:
Diagnosis coding vs. design type
Creator:
Dave Hewett
Date:
6/8/2017
Text:
I have an extremely short Trans Tib. Unfortunately, he was not successful
in a TT prosthesis and decided a trans femoral design was a better
functional design for his needs.
My question is what is the experience in this situation billing Medicare
when the amputation level (TT) is different than the L code design (Trans
femoral) from a claim submission point of view?
We have excellent documentation from the MD for the design. I'm just
inquiring if I should expect a automatic denial and plan to fight this one.
Thanks,
Dave
--
David Hewett, CP, ATP, BOCPO
ADAPTIVE PROSTHETICS & ORTHOTICS, llc
52 National Dr, Glastonbury, CT 06033
860-633-7298
<URL Redacted>
in a TT prosthesis and decided a trans femoral design was a better
functional design for his needs.
My question is what is the experience in this situation billing Medicare
when the amputation level (TT) is different than the L code design (Trans
femoral) from a claim submission point of view?
We have excellent documentation from the MD for the design. I'm just
inquiring if I should expect a automatic denial and plan to fight this one.
Thanks,
Dave
--
David Hewett, CP, ATP, BOCPO
ADAPTIVE PROSTHETICS & ORTHOTICS, llc
52 National Dr, Glastonbury, CT 06033
860-633-7298
<URL Redacted>
Citation
Dave Hewett, “Diagnosis coding vs. design type,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/254780.
