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.

84 Topics 0 Followers

Surety bond as example of what not to do
9/11/24, 10:47 AM • Paul Kesselman 9/11/24, 10:47 AM

1

1
Posts

197
Views

Paul Kesselman
9/11/24, 10:47 AM

A recent encounter with a provider of DMEPOS (not a podiatrist, but a pedorthist) shoul...
L1951 3rd posting
8/21/24, 8:07 AM • Paul Kesselman 8/21/24, 8:07 AM

1

1
Posts

409
Views

Paul Kesselman
8/21/24, 8:07 AM

The past two forum postings have reviewed the DMEPOS prior authorization process and the clinical...
L1951 2nd forum posting
8/7/24, 7:50 AM • Paul Kesselman 8/7/24, 7:50 AM

1

1
Posts

411
Views

Paul Kesselman
8/7/24, 7:50 AM

The last forum discussed the DMEPOS prior authorization program as one way of CMS stemming the fl...
Prior Authorization Program
7/24/24, 8:07 AM • Paul Kesselman 7/24/24, 8:07 AM

1

1
Posts

205
Views

Paul Kesselman
7/24/24, 8:07 AM

Medicare, in its attempt to stem payments to providers and reduce fraud and abuse, CMS has now ex...
Proper Documentation for Custom Foot Orthotics 9
6/24/24, 5:40 PM • Paul Kesselman 6/24/24, 5:40 PM

1

1
Posts

555
Views

Paul Kesselman
6/24/24, 5:40 PM

Many clients have asked beyond the HCPCS codes for custom fabricated foot orthotics and casting c...
Proper Documentation for Custom Foot Orthotics 8
6/12/24, 9:25 AM • Paul Kesselman 6/12/24, 9:25 AM

1

1
Posts

449
Views

Paul Kesselman
6/12/24, 9:25 AM

Many clients have asked how to bill Medicare for custom foot orthotics when the patient’s s...
Proper Documentation for Custom Foot Orthotics 7
5/29/24, 12:04 PM • Paul Kesselman 5/29/24, 1:08 PM

2

2
Posts

467
Views

Richard Blake
5/29/24, 1:08 PM

Excellent discussion. Can not wait for the Medicare discussion next week!!! Rich Blake
Proper Documentation for Custom Foot Orthotics 6
5/14/24, 10:38 AM • Paul Kesselman 5/14/24, 10:38 AM

1

1
Posts

453
Views

Paul Kesselman
5/14/24, 10:38 AM

The last four installments in this forum dealt with the three steps of required documen...
Proper Documentation for Custom Foot Orthotics 5
4/10/24, 12:13 PM • Paul Kesselman 4/10/24, 12:13 PM

1

1
Posts

524
Views

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

1

1
Posts

435
Views

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

1

1
Posts

558
Views

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

1

1
Posts

728
Views

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

1

1
Posts

900
Views

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

1

1
Posts

167
Views

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

1

1
Posts

159
Views

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

1

1
Posts

1k
Views

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

1

1
Posts

253
Views

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

1

1
Posts

727
Views

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...
PK

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

1

1
Posts

210
Views

PK

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

1

1
Posts

255
Views

PK

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...

1
2
3
4 / 5
5

$0.00

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)