Compliance and reimbursement pearls | KRM Forum

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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When Same and Similar Meets Wedding Planning
6/17/26, 9:42 AM • Paul Kesselman 6/17/26, 9:42 AM

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Paul Kesselman
6/17/26, 9:42 AM

Not much has changed since this column began about the issue of Same and/or Similar. To pr...
Patients Status Post TMA: Addressing More Advanced Biomechanical Needs
6/11/26, 11:31 AM • Paul Kesselman 6/11/26, 11:31 AM

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Paul Kesselman
6/11/26, 11:31 AM

The first installment addressing the biomechanical needs of patients’ status post trans met...
Trans Metatarsal Amputation (TMA)
6/4/26, 8:30 AM • Paul Kesselman 6/4/26, 8:30 AM

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Paul Kesselman
6/4/26, 8:30 AM

A colleague asked are there common biomechanical traits and needs for patients who have undergone...
Prior Auth & Competitive Bidding
5/25/26, 7:04 AM • Paul Kesselman 5/25/26, 7:04 AM

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Paul Kesselman
5/25/26, 7:04 AM

Medicare, as with other third-party payers, has had to contend with an explosion of reimbursement...
Staying Current With DME Enrollment Requirements
5/21/26, 11:52 AM • Paul Kesselman 5/21/26, 11:52 AM

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Paul Kesselman
5/21/26, 11:52 AM

In last week’s column, we discussed several common DME enrollment issues. Two gro...
DME Enrollment Issues
5/14/26, 11:45 AM • Paul Kesselman 5/14/26, 11:45 AM

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Paul Kesselman
5/14/26, 11:45 AM

Over the past several months, many providers have discovered that their DME licenses (PTANs) are ...
CFO vs AFO
5/7/26, 9:27 AM • Paul Kesselman 5/7/26, 9:27 AM

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Paul Kesselman
5/7/26, 9:27 AM

Having recently attended an out of state podiatry conference, it provided an opportunit...
Add on codes
4/29/26, 10:50 AM • Paul Kesselman 4/29/26, 10:50 AM

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Paul Kesselman
4/29/26, 10:50 AM

Recently a colleague asked whether he could be reimbursed for a soft tissue interface f...
New AFO PA language
4/22/26, 11:04 AM • Paul Kesselman 4/22/26, 11:04 AM

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Paul Kesselman
4/22/26, 11:04 AM

Local Carrier Determinations (LCD) for all products and services provided by medical professional...
Second Pair Coverage for Custom Orthotics: What Clinicians Should Know
4/17/26, 7:46 AM • Paul Kesselman 4/17/26, 7:46 AM

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Paul Kesselman
4/17/26, 7:46 AM

A common question in practice is whether insurance will c...
Neuro Part 3: Advanced AFO Prescription
4/9/26, 8:58 AM • Paul Kesselman 4/9/26, 8:58 AM

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Paul Kesselman
4/9/26, 8:58 AM

This week’s issue builds on our previous discussions by moving beyond general AFO...
Coding vs Reimbursement Part 2
4/2/26, 1:02 PM • Paul Kesselman 4/2/26, 1:02 PM

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Paul Kesselman
4/2/26, 1:02 PM

In Part 1 we presented an overview of coding and began to ask some questions about reimbursement....
Coding vs Reimbursement Part 1
3/26/26, 12:52 PM • Paul Kesselman 3/26/26, 12:52 PM

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Paul Kesselman
3/26/26, 12:52 PM

Over the past few decades one of the most common questions posed by most providers is h...
Neuro Exam 2
3/19/26, 12:44 PM • Paul Kesselman 3/19/26, 12:44 PM

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Paul Kesselman
3/19/26, 12:44 PM

The last few installments of this column have provided some insights into how the neurological co...
Neuro Exam
3/12/26, 8:14 AM • Paul Kesselman 3/12/26, 8:14 AM

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Paul Kesselman
3/12/26, 8:14 AM

In a previous edition of this column, we began an initial discussion of the documentati...
Moratorium on new supplier enrollment
3/5/26, 1:26 PM • Paul Kesselman 3/5/26, 1:26 PM

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Paul Kesselman
3/5/26, 1:26 PM

Some late breaking news from CMS requires a slight delay in Part 2 of the elements of d...
Medical Necessity and AFO Coding: A Drop Foot Case Example
2/18/26, 10:16 AM • Paul Kesselman 2/18/26, 10:16 AM

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Paul Kesselman
2/18/26, 10:16 AM

Recently, a new coding forum entitled codinghelpline.com was launched enabling col...
Protecting Your Practice from Consolidated Billing
2/11/26, 1:32 PM • Paul Kesselman 2/11/26, 1:32 PM

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Paul Kesselman
2/11/26, 1:32 PM

Recently, a client was asked by Noridian (DME MAC A) to repay a few hundred dollars for...
Your DME Claim Went to the Wrong DME MAC?
2/4/26, 12:25 PM • Paul Kesselman 2/4/26, 12:25 PM

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Paul Kesselman
2/4/26, 12:25 PM

Here’s a Five-Minute, Permanent Fix This is a very common issue. Take a deep bre...
Patient with unknown ID 1
1/28/26, 10:17 AM • Paul Kesselman 1/28/26, 10:17 AM

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Paul Kesselman
1/28/26, 10:17 AM

Changed Medicare Beneficiary Identifier (MBI) I and now your office is hit with a new d...

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Compliance and reimbursement pearls

Latest posts

When Same and Similar Meets Wedding Planning

Patients Status Post TMA: Addressing More Advanced Biomechanical Needs

Trans Metatarsal Amputation (TMA)