Re: OPINION- DELIVERING A CUSTOM PROSTHETIC TO A SNF PATIENT
CINDY ANDERSON
Description
Collection
Title:
Re: OPINION- DELIVERING A CUSTOM PROSTHETIC TO A SNF PATIENT
Creator:
CINDY ANDERSON
Date:
4/16/2021
Text:
Elizabeth,
Orthotics are subject to the two day discharge rule. Any code appearing on the attached list is exempt from consolidated billing. A prosthesis is a covered service during a part A stay with the exception of the codes not appearing on this list.
Cindy Anderson
Manfredi Orthotic & Prosthetic Affiliates
<Email Address Redacted>
> On 04/14/2021 2:06 PM Elizabeth Roof < <Email Address Redacted> > wrote:
>
>
> Our office was referred by an orthopedic surgeon to fit a new amputee with a prosthesis and we have been working with the SNF facility that the patient is in currently to do so. It has come down to delivering out the item and we notified the facility that we are unable to deliver a prosthesis to a patient in a part A stay in a SNF bed and the facility is responsible for the cost of the item. We told them that we cannot give the patient the item until 2 days before he is discharged home and they don’t understand this. They want to be able to bill for therapy minutes on gait training and teaching him how to properly don/doff the prosthesis. The PT called the office today and stated that another local O&P facility in the area has delivered items out to them before for patients to complete therapy still in the SNF part A stay and she doesn’t understand why we don’t do the same. I’ve sent her all the items regarding proper Medicare billing practices for SNF stay patients on the Noridian Medicare Portal, but I am curious if any other facility has run into this same issue and what you’ve done to help educate other medical professionals on the billing guidelines we are to follow to stay compliant with Medicare. We of course want to continue to see the patient regarding his prosthesis as we have finished all fabrication, but also want to avoid improper billing procedures set forth by the payer.
>
> Any tips or advice would be greatly appreciated!
>
> Thanks in advance!
>
> Liz Roof,
> Billing Supervisor & Office Manager
> 15418 West Center Road
> Omaha, NE 68144
>
> Sent from Mail< <URL Redacted> > for Windows 10
>
>
>
Orthotics are subject to the two day discharge rule. Any code appearing on the attached list is exempt from consolidated billing. A prosthesis is a covered service during a part A stay with the exception of the codes not appearing on this list.
Cindy Anderson
Manfredi Orthotic & Prosthetic Affiliates
<Email Address Redacted>
> On 04/14/2021 2:06 PM Elizabeth Roof < <Email Address Redacted> > wrote:
>
>
> Our office was referred by an orthopedic surgeon to fit a new amputee with a prosthesis and we have been working with the SNF facility that the patient is in currently to do so. It has come down to delivering out the item and we notified the facility that we are unable to deliver a prosthesis to a patient in a part A stay in a SNF bed and the facility is responsible for the cost of the item. We told them that we cannot give the patient the item until 2 days before he is discharged home and they don’t understand this. They want to be able to bill for therapy minutes on gait training and teaching him how to properly don/doff the prosthesis. The PT called the office today and stated that another local O&P facility in the area has delivered items out to them before for patients to complete therapy still in the SNF part A stay and she doesn’t understand why we don’t do the same. I’ve sent her all the items regarding proper Medicare billing practices for SNF stay patients on the Noridian Medicare Portal, but I am curious if any other facility has run into this same issue and what you’ve done to help educate other medical professionals on the billing guidelines we are to follow to stay compliant with Medicare. We of course want to continue to see the patient regarding his prosthesis as we have finished all fabrication, but also want to avoid improper billing procedures set forth by the payer.
>
> Any tips or advice would be greatly appreciated!
>
> Thanks in advance!
>
> Liz Roof,
> Billing Supervisor & Office Manager
> 15418 West Center Road
> Omaha, NE 68144
>
> Sent from Mail< <URL Redacted> > for Windows 10
>
>
>
Citation
CINDY ANDERSON, “Re: OPINION- DELIVERING A CUSTOM PROSTHETIC TO A SNF PATIENT,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/255494.
