KevinRoot Medical

Compliance and reimbursement pearls | KevinRoot Medical

Compliance and reimbursement pearls

Monthly column on billing and coding issues important to orthotic providers. These columns will provide you with a brief but thorough rationale on orthotic/prosthetic policies and billing practices.

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Proper Documentation for Custom Foot Orthotics 5
4/10/24, 12:13 PM • Paul Kesselman 4/10/24, 12:13 PM

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Paul Kesselman
4/10/24, 12:13 PM

The last four installments in this forum dealt with the three steps of required documentation f...
Proper Documentation for Custom Foot Orthotics 4
3/27/24, 10:54 AM • Paul Kesselman 3/27/24, 10:54 AM

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Paul Kesselman
3/27/24, 10:54 AM

The last three installments in this forum dealt with the first three steps of required ...
Proper Documentation for Custom Foot Orthotics 3
2/28/24, 1:15 PM • Paul Kesselman 2/28/24, 1:15 PM

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Paul Kesselman
2/28/24, 1:15 PM

The last two installments in this forum dealt with the first two steps of required documentation ...
Proper Documentation for Custom Foot Orthotics 2
2/13/24, 12:52 PM • Paul Kesselman 2/13/24, 12:52 PM

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Paul Kesselman
2/13/24, 12:52 PM

Assuming all the clinical requirements for the medical necessity for custom foot orthotics have b...
Proper documentation for custom foot orthotics 1
1/31/24, 8:58 AM • Paul Kesselman 1/31/24, 8:58 AM

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Paul Kesselman
1/31/24, 8:58 AM

What must I document in my patient’s chart to document medical necessity for custom foot or...
SWO Do I need one
1/17/24, 10:05 AM • Paul Kesselman 1/17/24, 10:05 AM

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Paul Kesselman
1/17/24, 10:05 AM

Several colleagues have recently been hit with audit denials for an incomplete or absent Standard...
Virtual Prescribing
1/9/24, 2:10 PM • Paul Kesselman 1/9/24, 2:10 PM

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Paul Kesselman
1/9/24, 2:10 PM

A great question was recently raised as to whether a physician can prescribe an AFO (or any devic...
L5000 coverage
12/13/23, 10:14 AM • Paul Kesselman 12/13/23, 10:14 AM

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Paul Kesselman
12/13/23, 10:14 AM

If a patient is not a diabetic and has a partial foot amputation does Medicare cover a partial fo...
Football and DME
11/29/23, 10:36 AM • Paul Kesselman 11/29/23, 10:36 AM

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Paul Kesselman
11/29/23, 10:36 AM

Often clinicians groan about third party payers and their devious schemes to deny their claims. A...
What does the KX modifier signify and when should I use it?
11/15/23, 1:44 PM • Paul Kesselman 11/15/23, 1:44 PM

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Paul Kesselman
11/15/23, 1:44 PM

The KX modifier is a payment modifier used almost exclusively with HCPCS codes. It signifies to t...
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I am getting messages that my CEDI and Tax ID Dont Match
10/25/23, 7:54 AM • Paul Kesselman 10/25/23, 7:54 AM

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Paul Kesselman
10/25/23, 7:54 AM

I am new to Medicare DME and my claims are not processing as I am getting several error messages ...
PK

Can I be paid for an AFO for my patient who recently passed away?
10/4/23, 11:51 AM • Paul Kesselman 10/4/23, 11:51 AM

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Paul Kesselman
10/4/23, 11:51 AM

A common scenario occurs when an order is billing filled, or after being completed but not yet de...
PK

Do I need a contract with KevinRoot and my other vendors?
9/19/23, 8:08 AM • Paul Kesselman 9/19/23, 8:08 AM

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Paul Kesselman
9/19/23, 8:08 AM

As of November 2022, the National Supplier Clearinghouse ceased to exist and the DMEPOS enrolment...
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DME Policies for Medicare Advantage (part C) Policyholders
9/6/23, 3:54 PM • Paul Kesselman 9/6/23, 3:54 PM

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Paul Kesselman
9/6/23, 3:54 PM

Medicare Part C plans while legally required to provide coverage to the same services/products as...
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Medicare Fee for Service (FFS) DME Policy
8/23/23, 4:06 PM • Paul Kesselman 8/23/23, 4:06 PM

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Paul Kesselman
8/23/23, 4:06 PM

Unlike local FFS Medicare, which often have different Local Coverage Determinations (LCD), all fo...
Biling Orthotic and Prosthetics of the Lower Extremity
8/2/23, 9:24 AM • Paul Kesselman 8/2/23, 9:24 AM

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Paul Kesselman
8/2/23, 9:24 AM

I am delighted that KevinRoot Medical have invited me to provide a twice monthly column on billin...

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Compliance and reimbursement pearls

Proper Documentation for Custom Foot Orthotics 5 4/10/24, 12:13 PM • Paul Kesselman 4/10/24, 12:13 PM

Proper Documentation for Custom Foot Orthotics 4 3/27/24, 10:54 AM • Paul Kesselman 3/27/24, 10:54 AM

Proper Documentation for Custom Foot Orthotics 3 2/28/24, 1:15 PM • Paul Kesselman 2/28/24, 1:15 PM

Proper Documentation for Custom Foot Orthotics 2 2/13/24, 12:52 PM • Paul Kesselman 2/13/24, 12:52 PM

Proper documentation for custom foot orthotics 1 1/31/24, 8:58 AM • Paul Kesselman 1/31/24, 8:58 AM

SWO Do I need one 1/17/24, 10:05 AM • Paul Kesselman 1/17/24, 10:05 AM

Virtual Prescribing 1/9/24, 2:10 PM • Paul Kesselman 1/9/24, 2:10 PM

L5000 coverage 12/13/23, 10:14 AM • Paul Kesselman 12/13/23, 10:14 AM

Football and DME 11/29/23, 10:36 AM • Paul Kesselman 11/29/23, 10:36 AM

What does the KX modifier signify and when should I use it? 11/15/23, 1:44 PM • Paul Kesselman 11/15/23, 1:44 PM

I am getting messages that my CEDI and Tax ID Dont Match 10/25/23, 7:54 AM • Paul Kesselman 10/25/23, 7:54 AM

Can I be paid for an AFO for my patient who recently passed away? 10/4/23, 11:51 AM • Paul Kesselman 10/4/23, 11:51 AM

Do I need a contract with KevinRoot and my other vendors? 9/19/23, 8:08 AM • Paul Kesselman 9/19/23, 8:08 AM

DME Policies for Medicare Advantage (part C) Policyholders 9/6/23, 3:54 PM • Paul Kesselman 9/6/23, 3:54 PM

Medicare Fee for Service (FFS) DME Policy 8/23/23, 4:06 PM • Paul Kesselman 8/23/23, 4:06 PM

Biling Orthotic and Prosthetics of the Lower Extremity 8/2/23, 9:24 AM • Paul Kesselman 8/2/23, 9:24 AM

Proper Documentation for Custom Foot Orthotics 5
4/10/24, 12:13 PM • Paul Kesselman 4/10/24, 12:13 PM

Proper Documentation for Custom Foot Orthotics 4
3/27/24, 10:54 AM • Paul Kesselman 3/27/24, 10:54 AM

Proper Documentation for Custom Foot Orthotics 3
2/28/24, 1:15 PM • Paul Kesselman 2/28/24, 1:15 PM

Proper Documentation for Custom Foot Orthotics 2
2/13/24, 12:52 PM • Paul Kesselman 2/13/24, 12:52 PM

Proper documentation for custom foot orthotics 1
1/31/24, 8:58 AM • Paul Kesselman 1/31/24, 8:58 AM

SWO Do I need one
1/17/24, 10:05 AM • Paul Kesselman 1/17/24, 10:05 AM

Virtual Prescribing
1/9/24, 2:10 PM • Paul Kesselman 1/9/24, 2:10 PM

L5000 coverage
12/13/23, 10:14 AM • Paul Kesselman 12/13/23, 10:14 AM

Football and DME
11/29/23, 10:36 AM • Paul Kesselman 11/29/23, 10:36 AM

What does the KX modifier signify and when should I use it?
11/15/23, 1:44 PM • Paul Kesselman 11/15/23, 1:44 PM

I am getting messages that my CEDI and Tax ID Dont Match
10/25/23, 7:54 AM • Paul Kesselman 10/25/23, 7:54 AM

Can I be paid for an AFO for my patient who recently passed away?
10/4/23, 11:51 AM • Paul Kesselman 10/4/23, 11:51 AM

Do I need a contract with KevinRoot and my other vendors?
9/19/23, 8:08 AM • Paul Kesselman 9/19/23, 8:08 AM

DME Policies for Medicare Advantage (part C) Policyholders
9/6/23, 3:54 PM • Paul Kesselman 9/6/23, 3:54 PM

Medicare Fee for Service (FFS) DME Policy
8/23/23, 4:06 PM • Paul Kesselman 8/23/23, 4:06 PM

Biling Orthotic and Prosthetics of the Lower Extremity
8/2/23, 9:24 AM • Paul Kesselman 8/2/23, 9:24 AM