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Multiple DME Question?

  1. #1
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    Seattle First Hill
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    Cool Multiple DME Question?
    Medical Coding Books
    Our podiatry dept. is fitting patients for multiple DME products, like L3400s and L3001s, and it's my understanding that the patients are coming in with several shoes at a time. What if the code only allows for 2 units but the phys. gave the patient more than 2 of the product?? How do you code this, if you can?

  2. #2
    Location
    Sioux Falls South Dakota
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    358
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    Quote Originally Posted by sarah545 View Post
    Our podiatry dept. is fitting patients for multiple DME products, like L3400s and L3001s, and it's my understanding that the patients are coming in with several shoes at a time. What if the code only allows for 2 units but the phys. gave the patient more than 2 of the product?? How do you code this, if you can?
    You can look at the code definition - for example, L3001 says "Foot, insert, removable, molded to patient model, [U][B]each." Therefore, you would use units for any more than one. Code L3400 does not say one, but it is also not defined as multiple such as "wedge(s)", but only says wedge - so it is also one.

    However, if you furnish more than two to the patient, you will come up against the Medically Unlikely Edits. Most insurance companies will allow for one pair only.

    Hope this helps,
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

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