Medical Billing Forum

Billing => Billing => : billingmom June 05, 2013, 01:19:36 PM

: Question about billing Prosthetics and orthotics
: billingmom June 05, 2013, 01:19:36 PM

hello,
I'll be billing for a new specialty and any help from the forum will be appreciated.  I've never billed this specialty.  I know they use L codes and modifiers so if anyone has any suggestions such as training books please send it my way.


Thank you

: Re: Question about billing Prosthetics and orthotics
: Michele June 11, 2013, 03:42:37 PM

What is your experience in?  The claims should be coming over to you already coded so you should be fine.  I've done some billing of orthotics and it's pretty straight forward.

: Re: Question about billing Prosthetics and orthotics
: shanbull June 13, 2013, 12:26:58 PM

I have a PDF with the complete list of DME codes (including prosthetics and orthotics) but I can't for the life of me remember what website I got it from. Could I email it to you?

Edit: HA nevermind, I found it:
http://www.hfs.illinois.gov/assets/da12234c.pdf (http://www.hfs.illinois.gov/assets/da12234c.pdf)

Ignore that it's for Illinois, the codes work for any state.

: Re: Question about billing Prosthetics and orthotics
: Merry June 14, 2013, 01:50:40 AM

Generally these are HCPCS codes and can be used by any carrier. BUT..some insurance companies (Medicaid) sometimes will have you use specific modifiers so please be cautious. As Michele noted, these should be coming to you already coded.
And if you are sending claims to Medicare, these claims do not go to your regular MAC (Medicare). Please go online and check where you send your DME (Durable Medical Equipment).