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DME - Help!

  1. Default Dme l1800 & l1815
    Clearnace Sale
    Since codes L1800 & L1815 have been deleted, what codes should be used in their place?

  2. #12
    Portland Metro Chapter
    Angry patient billing
    Quote Originally Posted by montie99 View Post
    So can we bill the pt for these?
    We have every patient (except Medicare & Medicaid) sign an agreement that explains the orthotic may not be covered by their payer, is not returnable, and acknowledges they are ultimately responsible for payment. These agreements are kept on file in our back office and will ultimately be scanned into our EMR system.

    When implementing A4466, we used the fee for the highest priced article but enter the type of orthotic in our narrative field for the claim. This is working for us.

    All Medicare patients must sign an ABN and we bill their orthotics with the GA modifier. For Medicaid patients, we do our best to get a prior authorization but lots of money walks out the door. This remains one of my biggest frustrations.

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