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Thread: A5512 molded insert billing

  1. #1

    Default A5512 molded insert billing

    AAPC: Back to School

    anyone know how many units is a provider allow to bill for this, and is there a limit on how many?
    Marilyn CPC, CPC-H, CEMC

  2. #2
    Join Date
    Apr 2007
    Wichita, KS


    For HCPC A5512 6 units are allowed per year to be billed to Medicare. Be sure to have "Statement of Certifying Physician From Diabetes Doctor" from the physician treating the patient's diabetes, the treating physician's records will need to show that the patient has diabetes and documentation of the foot deformity used to qualify the patient for therapeutic shoes for persons with diabetes program, and to use the KX modifier once the required documentation is receive. A properly written SSCP will provide the documentation requirement for the certifying physician. I do not know what region you are in but DMAC Jurisdiction D - Noridian is having a webinar July 28, 2009 at 3:00pm (Central Time) for Therapeutic Shoes for Persons with Diabetes. This session will include: coverage, payment guidelines, coding guidelines, documentation requirements. You will need to go to Noridian website to register. I have found these webinars put on by Medicare contractors such as Noridian very educational especially when I was starting out.

    In our office we have a saying for when the patient's complain about the looks of diabetic shoes "This is not the pretty shoe program"[/LEFT][/CENTER]
    Tammy Hulsey-Ferguson, CPC
    Past President AAPC Wichita, KS Local Chapter

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