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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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...
Deductible issues and HSA
1/14/26, 10:03 AM • Paul Kesselman 1/14/26, 10:03 AM

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Paul Kesselman
1/14/26, 10:03 AM

As you start the New Year, be aware that the annual deductibles for most plans reset and start Ja...
Prosthetics when
12/17/25, 2:12 PM • Paul Kesselman 12/17/25, 2:12 PM

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Paul Kesselman
12/17/25, 2:12 PM

Many patients, including those with diabetes, PAD, post trauma, etc. frequently present to the ...
Your Role in Preventing DMEPOS Fraud and Protecting Patient Data
12/10/25, 11:38 AM • Paul Kesselman 12/10/25, 11:38 AM

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Paul Kesselman
12/10/25, 11:38 AM

Recently the Office of Inspector General provided a video on fraud in the DMEPOS world. To say th...
Wear that AFO
11/26/25, 12:17 PM • Paul Kesselman 11/26/25, 12:17 PM

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Paul Kesselman
11/26/25, 12:17 PM

A recent article in Rosalind Franklin Medical School Fall/Winter 2025 edition, sparked ...
Hours at time of inspection
11/19/25, 1:06 PM • Paul Kesselman 11/19/25, 1:06 PM

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Paul Kesselman
11/19/25, 1:06 PM

The last installment of this column presented some issues with the inspection process d...
Quality standards
11/12/25, 9:32 AM • Paul Kesselman 11/12/25, 9:32 AM

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Paul Kesselman
11/12/25, 9:32 AM

A previous bulletin raised a new term for most reading this bulletin, “Quality Standards Ap...
3D Orthotics and Prosthetics
11/5/25, 10:36 AM • Paul Kesselman 11/5/25, 10:36 AM

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Paul Kesselman
11/5/25, 10:36 AM

Recently many providers have questioned whether 3-D manufactured orthotics and prosthetics can be...
Choosing the Right AFO for the Patient - Part 6
10/29/25, 1:12 PM • Paul Kesselman 10/29/25, 1:12 PM

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Paul Kesselman
10/29/25, 1:12 PM

The past five articles have attempted to provide a crash course on AFOs. This is a very...
Choosing the Right AFO for the Patient - Part 5
10/22/25, 9:00 AM • Paul Kesselman 10/22/25, 9:00 AM

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Paul Kesselman
10/22/25, 9:00 AM

In four short articles this series has covered a significant amount of material on the ...

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