Responses to billing question re hot cold gel pack on spinal orthosis
David Hendricks
Description
Collection
Title:
Responses to billing question re hot cold gel pack on spinal orthosis
Creator:
David Hendricks
Date:
10/22/2021
Text:
Dear Colleagues,
Thanks to those who responded to my question about billing Medicare or insurance for a hot/cold therapy gel pack that is attached to a brace. All answered that, no, you can’t. The brace you can bill for; the gel pack and holder, you cannot. A couple of responders suggested using a miscellaneous code and having the patient sign an ABN. Other responders pointed out that an orthosis meant to be put on the patient after surgery should be billed to the hospital.
I appreciate all responses. They were quite helpful.
A follow-up question: Assume that, after a patient is discharged, the doctor sent that patient to the orthotist with this prescription: “Fit patient with Panther MP with hot/cold gel pack attached.” Could the orthotist bill Medicare (or insurance) for the LSO but not the gel pack, and then have the patient pay cash for the gel pack?
Best Regards,
David Hendricks
David Hendricks, CPO
President
Blue Diamond Orthopedic
6439 Milner Blvd, Suite 4
Orlando, FL 32809
<Email Address Redacted> <mailto:<Email Address Redacted>>
Phone: 407-613-2001
-----Original Message-----
From: Lesleigh Sisson < <Email Address Redacted> >
Sent: Thursday, October 21, 2021 3:04 PM
To: David Hendricks < <Email Address Redacted> >
Subject: Re: [OANDP-L] Billing question - hot cold gel pack on spinal orthosis
No
Sent from my iPhone
> On Oct 21, 2021, at 3:01 PM, David Hendricks < <Email Address Redacted> <mailto:<Email Address Redacted>>> wrote:
>
> Dear Colleagues,
>
> Is there a way to bill Medicare for a spinal orthosis with a hot/cold gel pack attached? Spine surgeons order these for patients about to have decompression surgery, for use immediately after the surgery. The orthosis has an L-code, but is there a way for an orthotist to bill the gel pack attached to it?
>
> Thanks, in advance, for your responses.
>
> Regards,
>
> David Hendricks
> David Hendricks, CPO
> President
> Blue Diamond Orthopedic
> 6439 Milner Blvd, Suite 4
> Orlando, FL 32809
> <Email Address Redacted> <mailto:<Email Address Redacted><mailto:<Email Address Redacted>: <Email Address Redacted> >>
> Phone: 407-613-2001
>
>
>
Thanks to those who responded to my question about billing Medicare or insurance for a hot/cold therapy gel pack that is attached to a brace. All answered that, no, you can’t. The brace you can bill for; the gel pack and holder, you cannot. A couple of responders suggested using a miscellaneous code and having the patient sign an ABN. Other responders pointed out that an orthosis meant to be put on the patient after surgery should be billed to the hospital.
I appreciate all responses. They were quite helpful.
A follow-up question: Assume that, after a patient is discharged, the doctor sent that patient to the orthotist with this prescription: “Fit patient with Panther MP with hot/cold gel pack attached.” Could the orthotist bill Medicare (or insurance) for the LSO but not the gel pack, and then have the patient pay cash for the gel pack?
Best Regards,
David Hendricks
David Hendricks, CPO
President
Blue Diamond Orthopedic
6439 Milner Blvd, Suite 4
Orlando, FL 32809
<Email Address Redacted> <mailto:<Email Address Redacted>>
Phone: 407-613-2001
-----Original Message-----
From: Lesleigh Sisson < <Email Address Redacted> >
Sent: Thursday, October 21, 2021 3:04 PM
To: David Hendricks < <Email Address Redacted> >
Subject: Re: [OANDP-L] Billing question - hot cold gel pack on spinal orthosis
No
Sent from my iPhone
> On Oct 21, 2021, at 3:01 PM, David Hendricks < <Email Address Redacted> <mailto:<Email Address Redacted>>> wrote:
>
> Dear Colleagues,
>
> Is there a way to bill Medicare for a spinal orthosis with a hot/cold gel pack attached? Spine surgeons order these for patients about to have decompression surgery, for use immediately after the surgery. The orthosis has an L-code, but is there a way for an orthotist to bill the gel pack attached to it?
>
> Thanks, in advance, for your responses.
>
> Regards,
>
> David Hendricks
> David Hendricks, CPO
> President
> Blue Diamond Orthopedic
> 6439 Milner Blvd, Suite 4
> Orlando, FL 32809
> <Email Address Redacted> <mailto:<Email Address Redacted><mailto:<Email Address Redacted>: <Email Address Redacted> >>
> Phone: 407-613-2001
>
>
>
Citation
David Hendricks, “Responses to billing question re hot cold gel pack on spinal orthosis,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/255618.
