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Thread: Dme providers - l3670

  1. #1

    Default Dme providers - l3670

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    We are having difficulty getting paid by Blue Shield for the sling we provide for our patients who undergo rotator cuff surgery, biceps repairs. We use the sling with the pillow and ball coded as L3670.

    Blue Shield supposedly expired the code but I heard it was being re-instated. Does anyone have any information on this such as was it reinstated and if so, when was in effect again, maybe even reference the site.

    Thank you so much

    Denise

  2. #2
    Join Date
    Apr 2007
    Location
    North Carolina
    Posts
    3,127

    Default

    Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Updates
    The following HCPCS codes will not be discontinued as of December 31, 2010:


    L3660 SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND WEBBING, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
    SD: Abduct restrainer canvas&web

    L3670 SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT
    SD: Acromio/clavicular canvas&we

    L3675 SHOULDER ORTHOSIS, VEST TYPE ABDUCTION RESTRAINER, CANVAS WEBBING TYPE OR EQUAL, PREFABRICATED INCLUDES FITTING AND ADJUSTMENT
    SD: Canvas vest SO

    These three “L” codes will continue to stay active codes for January 1, 2011. Instruction for billing and payment will remain the same for these three “L” codes. Contractors shall make payment for codes L3660, L3670, and L3675 with dates of service on or after January 1, 2011

    https://www.cms.gov/transmittals/downloads/R833OTN.pdf

    Pg. 6

  3. #3

    Default Rebecca L3670

    Rebecca - thank you for your input about the shoulder orthosis. We are having a problem with Blue Shield of Mass paying for L3670. For some reason it will not even go thru electronically. We are using the place of service "home" as instructed but then again we have not been doing DME billing very long.

    We also need to establish a waiver for our DME products and do not know where to begin. If you have any insight with regard to this or can fax me something resembling a waiver it will be appreciated (508-650-3547 fax).

    Forever grateful--

    Denise

  4. #4
    Join Date
    Apr 2007
    Location
    North Carolina
    Posts
    3,127

    Default

    For DME, the place of service is considered to be the place where the beneficiary will primarily use the DME item. If the patient is primarily using the DME in the home, POS 12 would be correct.

    I wonder if your clearinghouse is the actually problem. We attempted to electronically submit L3670 and kept receiving denials. Once I had proof that this HCPCS code was reinstated, the clearinghouse modified their edits so that the code would be released.

    Below are a couple of links you might find helpful.


    http://www.cms.gov/transmittals/downloads/R2132CP.pdf

    https://www.cms.gov/center/dme.asp

    I'll see if I have something I can fax you if someone else doesn't first...
    Last edited by RebeccaWoodward*; 03-07-2011 at 09:26 AM.

  5. #5

    Default RebeccaWoodward

    Rebecca -

    You are amazing - thank you for the clue about the clearinghouse. I will advise the billing supervisor and have her investigate that aspect.

    I really and truly appreciate your help.

    Thank you !!!

    Have a great day!!

    Denise

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