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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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 ...
Choosing the Right AFO for the Patient - Part 4
10/9/25, 1:34 PM • Paul Kesselman 10/9/25, 1:34 PM

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Paul Kesselman
10/9/25, 1:34 PM

In continuing the discussion of choosing the right AFO for the Patient. We have now assumed that ...
Choosing the Right AFO for the patient - Part 3
10/8/25, 7:47 AM • Paul Kesselman 10/8/25, 7:47 AM

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Paul Kesselman
10/8/25, 7:47 AM

In the two previous installments of Choosing the Right AFO for the patient, the issues of OTC and...
Choosing the Right AFO for the patient - Part 2
10/1/25, 2:16 PM • Paul Kesselman 10/1/25, 2:16 PM

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Paul Kesselman
10/1/25, 2:16 PM

Part 1 of this series presented some issues to address with regards to OTC and custom fitted orth...
Choosing the Right AFO for the patient - Part 1
9/19/25, 2:03 PM • Paul Kesselman 9/19/25, 2:03 PM

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Paul Kesselman
9/19/25, 2:03 PM

A recent phone call from a retired colleague concerning their family members’ AFO status is...
Medicare Advantage Coverage of Foot Orthotics
9/17/25, 8:47 AM • Paul Kesselman 9/17/25, 8:47 AM

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Paul Kesselman
9/17/25, 8:47 AM

A recent question to an online forum posed this question: Does Medicare Advantage provide covera...
Retired and Audited
9/9/25, 7:07 AM • Paul Kesselman 9/9/25, 7:07 AM

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Paul Kesselman
9/9/25, 7:07 AM

I retired from practice about three years ago and sold the practice. Now the DME MAC (CGS) agency...
How does one deal with a disgruntled patient who newly presents to your office with a shopping bag full of foot
9/2/25, 9:17 AM • Paul Kesselman 9/2/25, 9:17 AM

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Paul Kesselman
9/2/25, 9:17 AM

So, if you have a disgruntled patient with a shopping bag of foot orthotics which have failed to ...
How do I deal with a patient with a shopping bag full of orthotics
8/27/25, 7:49 AM • Paul Kesselman 8/27/25, 7:49 AM

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Paul Kesselman
8/27/25, 7:49 AM

How does one deal with a disgruntled patient who newly presents to your office with a shopping ba...
Foot Orthotics and Medicare
8/19/25, 10:21 AM • Paul Kesselman 8/19/25, 10:21 AM

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Paul Kesselman
8/19/25, 10:21 AM

A provider once told me that one can bill Medicare to get paid for orthotic using the KX modifier...
Stark Issues
8/12/25, 10:11 AM • Paul Kesselman 8/12/25, 10:11 AM

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Paul Kesselman
8/12/25, 10:11 AM

I am concerned that I may be violating Stark issues because of some materials I read in another f...
Do I need FA and SB
8/6/25, 8:28 AM • Paul Kesselman 8/6/25, 8:28 AM

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Paul Kesselman
8/6/25, 8:28 AM

I've recently heard that Medicare to combat fraud is going to institute a yearly Facility Accredi...

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Compliance and reimbursement pearls

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