October 2005 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 have two patients that are non-diabetic Medicare patients, and the doctor has prescribed an AFO/Ritchie brace (L-1960). Will Medicare cover this? Is it based on diabetes or other diagnosis?
A: According to DMERC, the purpose of a brace is to support a weak or deformed body member or to restrict or eliminate motion in a diseased or injured part of the body. When an AFO for an ambulatory patient and any related addition is used solely for the treatment of edema and/or for the prevention or treatment of a pressure ulcer, it will be denied as non-covered. L-1960 is used for an ankle foot orthosis which is worn when a patient is ambulatory.
Q: I recently moved my practice to a new location. I have direct deposit for my Medicare payments. Do I still need to notify Medicare of my new address, and if so, how would I go about doing this?
A: You will need to obtain a Medicare supplier enrollment application (form CMS855S). For a change of address, you will need to fill out section 1, 2, 4, 13, and 15 only. The completed form should be mailed to National Supplier Clearinghouse, PO Box 100142, Columbia, South Carolina, 29202-3142. Along with the completed form, you will need to attach a copy of all appropriate locationspecifi c licenses that show your new address. Ensure that your insurance policy indicates your physical address is covered. If you have additional questions, you can contact NSC at 866.238.9652 or visit www.palmettoGBA.com
We invite readers to ask questions you may 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.