• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Coding L3000

Lcurless

New
Messages
8
Location
West College Corner, IN
Best answers
0
Please help.... When coding an L3000 orthotic for Medicare, does it need to be attached to a metal brace or does a shoe qualify as a brace to support medical necessity for KX modifier.
 
This is from our Medicare ( Noridian) Local Coverage Determination (LCD) for Orthopedic Footwear (L11456)
"Inserts and other shoe modifications (L3000-L3170, L3300-L3450, L3465-L3520, L3550-L3595) are covered if they are on a shoe that is an integral part of a covered brace and if they are medically necessary for the proper functioning of the brace. Shoes and related modifications, inserts, heel/sole replacements or shoe transfers billed without a KX modifier will be denied as noncovered because coverage is statutorily excluded. "
 
Top