September 2004 Issue
The future of your practice depends on knowledgeable billing and collection information. Understanding the full aspect of billing guidelines and procedures will effectively increase your reimbursement. This informative column will help providers and their staff with a better understanding of billing procedures and reimbursement strategies.
Q: I started using the new codes that replaced the A-Codes for diabetic shoes. Should I still bill with a KX in front of the K-0628 and K-0629?
A: The codes may have changed, but the modifiers stay the same. Anytime you bill for diabetic shoes or inserts, you would always use the KX modifier.
Q: I have a patient who came to my facility in a power wheelchair with a prescription for a unilateral prosthesis. Will Medicare cover this?
A: First, you need to know if Medicare paid for the patient's wheelchair. If so, Medicare will not cover the prosthesis since these two items would be conflicting. A power chair states the patient cannot ambulate, and a prosthesis says the patient can.
Q: I heard that Medicare would only accept claims that are in the new HIPAA format. Is this true?
A: Effective July 1, 2004, Medicare has modified its HIPAA contingency plan. The modification states that Medicare will continue to allow submission of noncompliant electronic claims. However, it will take 13 additional days to process these claims.
We invite readers to ask any questions you have regarding billing, collections, or any other information. To send your questions or for more information, contact:firstname.lastname@example.org
Acc-Q-Data provides billing, collections, and practice management software serving the O&P industry nationwide for over a decade.
Lisa Lake-Salmon is Executive Vice President, Acc-Q-Data Inc.