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DME - Help!

  1. #1
    Location
    Capital Coders, Columbia, SC
    Posts
    145
    Question DME - Help!
    Medical Coding Books
    For 2010, CMS has eliminated payment for orthotic devices/braces with elastic. For example, in the 2010 HCPCS book, codes L1800, and L1825 have been deleted. Replacement codes are not offered. What if we still dispense these items? Should we try a non-specific code, or does this make the items 'over the counter'? Thanks.

    Bill Hale, CPC

  2. #2
    Location
    North Carolina
    Posts
    3,126
    Default
    Bill,

    You're not the first person I have heard say this. My HCPCS book "HCPCS Level II Professional 2010" edition by Mag Mutual provides the crosswalk. The code is A4466.

    Below is a link that supports the new crosswalk code...

    https://www.noridianmedicare.com/dme...date_2010.html

  3. #3
    Location
    Capital Coders, Columbia, SC
    Posts
    145
    Default
    Rebecca, you're the best! Thanks!

  4. #4
    Location
    North Carolina
    Posts
    3,126
    Default
    Anytime!!!! Glad I could be of help...

  5. Default
    any crosswalk code for deleted HCPCS code L1901?

  6. #6
    Location
    Capital Coders, Columbia, SC
    Posts
    145
    Default
    Elizabeth,

    Click on the link posted by Rebecca. L1901 is included on the list braces, orthotics, belts, etc., which contain elastic material and are now categorized together under the non-covered code A4466. These items are now over-the-counter.

    Bill Hale, CPC

  7. Default
    So, how are you handling the billing of these codes since they are combining different priced supplies(in my system) under the "A4466" umbrella? I understand they are non-payable now but I believe we will still be supplying them to the patient.

  8. Smile anance
    Just checking comments on the L1800 code. Thanks for giving the replacement code! I was needing it to bill a claim just NOW!

  9. #9
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    Quote Originally Posted by efuhrmann View Post
    So, how are you handling the billing of these codes since they are combining different priced supplies(in my system) under the "A4466" umbrella? I understand they are non-payable now but I believe we will still be supplying them to the patient.
    Liz - when the supply is given to the patient, the fee for that specific supply has to be written on our charge sheet along with the description to be entered into the system. So we don't have a "set" fee for A4466, it has to be provided by the physician (they are given a list of these supply fees to choose from). Hope that helps.
    Lisa Bledsoe, CPC, CPMA

  10. #10
    Default
    So can we bill the pt for these?

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