AFO/KAFO LCD Response
Paula Rogerson-Doherty
Description
Collection
Title:
AFO/KAFO LCD Response
Creator:
Paula Rogerson-Doherty
Date:
9/3/2020
Text:
Hello All,
Good news, Noridian has clarified that the language applies to NOC codes.
Below is the communication I received back from the Medical Director at Noridian (Wilfred Mamuya, MD,PhD) regarding the information they previously provided and the concerns with revision to the LCD revision.
Paula,
Thanks for sharing your concerns with us.
The DME MACs have jointly discussed your concerns, which were also raised by one other supplier.
We believe the confusion exists with the migration of the miscellaneous code documentation requirements to the Standard Documentation Requirements (SDR) Policy Article. The NOC information simply moved to the Standard Documentation Article because that information applies to all NOC codes.
There has been no change in the documentation requirements for either miscellaneous codes (NOC) or the information requested for custom fabricated codes. For custom fabricated products that do not have specific HCPCS codes, the supplier needs to provide a complete and clear description of the item, including what makes this item unique, and a breakdown of charges (material and labor used in fabrication). This information should be entered in the narrative field of an electronic claim.
We will clarify in an upcoming revision to the AFO/KAFO Policy article.
Best,
Fred
Paula Rogerson-Doherty
Business & Administrative Manager
Rogerson Orthotics & Prosthetics
P: (617) 268-1135
F: (617)269-3373
<URL Redacted> < <URL Redacted> >
Confidentiality Notice: This email, including attachments, is covered by the Electronic Communications Privacy Act, 18 USC 2510-2521, and the HIPAA privacy regulations and, as such, is confidential and may be legally privileged. It is intended for the use of the individual or entity to which it is addressed and may contain certain information that is privileged, confidential, and exempt from disclosure under applicable law. If the reader of this email is not the intended recipient or agent responsible for delivering or copying this communication and attachments, you are hereby notified that any retention, dissemination, distribution, or copying of this communication is strictly prohibited. Please reply to the sender that you received it in error, then delete it. Thank you for your cooperation.
Good news, Noridian has clarified that the language applies to NOC codes.
Below is the communication I received back from the Medical Director at Noridian (Wilfred Mamuya, MD,PhD) regarding the information they previously provided and the concerns with revision to the LCD revision.
Paula,
Thanks for sharing your concerns with us.
The DME MACs have jointly discussed your concerns, which were also raised by one other supplier.
We believe the confusion exists with the migration of the miscellaneous code documentation requirements to the Standard Documentation Requirements (SDR) Policy Article. The NOC information simply moved to the Standard Documentation Article because that information applies to all NOC codes.
There has been no change in the documentation requirements for either miscellaneous codes (NOC) or the information requested for custom fabricated codes. For custom fabricated products that do not have specific HCPCS codes, the supplier needs to provide a complete and clear description of the item, including what makes this item unique, and a breakdown of charges (material and labor used in fabrication). This information should be entered in the narrative field of an electronic claim.
We will clarify in an upcoming revision to the AFO/KAFO Policy article.
Best,
Fred
Paula Rogerson-Doherty
Business & Administrative Manager
Rogerson Orthotics & Prosthetics
P: (617) 268-1135
F: (617)269-3373
<URL Redacted> < <URL Redacted> >
Confidentiality Notice: This email, including attachments, is covered by the Electronic Communications Privacy Act, 18 USC 2510-2521, and the HIPAA privacy regulations and, as such, is confidential and may be legally privileged. It is intended for the use of the individual or entity to which it is addressed and may contain certain information that is privileged, confidential, and exempt from disclosure under applicable law. If the reader of this email is not the intended recipient or agent responsible for delivering or copying this communication and attachments, you are hereby notified that any retention, dissemination, distribution, or copying of this communication is strictly prohibited. Please reply to the sender that you received it in error, then delete it. Thank you for your cooperation.
Citation
Paula Rogerson-Doherty, “AFO/KAFO LCD Response,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 24, 2024, https://library.drfop.org/items/show/255197.
