Billing Medicare - L5000 Toe Fillers
Richenda Janowitz
Description
Collection
Title:
Billing Medicare - L5000 Toe Fillers
Creator:
Richenda Janowitz
Date:
12/27/2021
Text:
Good morning ListServ,
What is everyone doing for L5000 (Toe Fillers) for Medicare patients
(Jurisdiction D)? L5000 is classified under lower limb prosthetic benefits
which have a reasonable useful lifetime of 5 years. I'm not seeing them
under any RUL exclusion. I called the Noridian Supplier Contact Center and
spoke with a representative that didn't know the answer. I've emailed the
PDAC contractor to see if they could provide any clarification, and am
waiting on a response. A lot of the toe fillers listed on the PDAC website
are made of the same material that a normal A5513 DM Custom Insert is made
from and diabetic patients are allowed three pairs a year. I have a hard
time imagining this type of toe filler lasts through the 5 year reasonable
useful lifetime period.
Does anyone have experience with billing these out to Medicare?
Thank you,
Richenda Janowitz, Claims and Accounts
Antelope Valley Orthotics & Prosthetics
What is everyone doing for L5000 (Toe Fillers) for Medicare patients
(Jurisdiction D)? L5000 is classified under lower limb prosthetic benefits
which have a reasonable useful lifetime of 5 years. I'm not seeing them
under any RUL exclusion. I called the Noridian Supplier Contact Center and
spoke with a representative that didn't know the answer. I've emailed the
PDAC contractor to see if they could provide any clarification, and am
waiting on a response. A lot of the toe fillers listed on the PDAC website
are made of the same material that a normal A5513 DM Custom Insert is made
from and diabetic patients are allowed three pairs a year. I have a hard
time imagining this type of toe filler lasts through the 5 year reasonable
useful lifetime period.
Does anyone have experience with billing these out to Medicare?
Thank you,
Richenda Janowitz, Claims and Accounts
Antelope Valley Orthotics & Prosthetics
Citation
Richenda Janowitz, “Billing Medicare - L5000 Toe Fillers,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/255784.
