The last four installments in this forum dealt with the three steps of required documentation for reimbursement for custom foot orthotics and L3000. To summarize those steps were proper cli...
Paul Kesselman
About me
five years of consulting experience in many areas of health policy providing expertise on Medicare and third party payment regulations.
He is a member of all four DME MAC Medicare Councils and has a regular column in Podiatry Management.
Posts made by Paul Kesselman
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Proper Documentation for Custom Foot Orthotics 6
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Proper Documentation for Custom Foot Orthotics 5
The last four installments in this forum dealt with the three steps of required documentation for reimbursement for custom foot orthotics and L3000. To summarize those steps were proper clinical do...
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Proper Documentation for Custom Foot Orthotics 4
The last three installments in this forum dealt with the first three steps of required documentation for reimbursement for custom foot orthotics. To summarize those steps were proper clinic...
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Proper Documentation for Custom Foot Orthotics 3
The last two installments in this forum dealt with the first two steps of required documentation for reimbursement for custom foot orthotics. To summarize those steps were proper clinical documenta...
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Proper Documentation for Custom Foot Orthotics 2
Assuming all the clinical requirements for the medical necessity for custom foot orthotics have been met, what other issues must the chart documentation address? There are two major issues which m...
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Proper documentation for custom foot orthotics 1
What must I document in my patient’s chart to document medical necessity for custom foot orthotics? This is a common question asked by many of my clients. There are many issues to address wit...
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SWO Do I need one
Several colleagues have recently been hit with audit denials for an incomplete or absent Standard Written Order (SWO). Why can’t Medicare get this right? A Standard Written Order in DME parl...
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Virtual Prescribing
A great question was recently raised as to whether a physician can prescribe an AFO (or any device) to a patient they are not physically examining? That is can telemedicine substitute for the in p...
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L5000 coverage
If a patient is not a diabetic and has a partial foot amputation does Medicare cover a partial foot filler (L5000) The short answer is that whether the patient is diabetic or not, the L5000 would ...
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Football and DME
Often clinicians groan about third party payers and their devious schemes to deny their claims. Are carriers out to get you or are they simply asking you to play by their rules? Let’s make a...
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What does the KX modifier signify and when should I use it?
The KX modifier is a payment modifier used almost exclusively with HCPCS codes. It signifies to the payer, whether Medicare or not, that the claim for whatever DMEPOS you are billing, has corrobora...
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Biling Orthotic and Prosthetics of the Lower Extremity
I am delighted that KevinRoot Medical have invited me to provide a twice monthly column on billing and coding issues important to orthotic providers. These columns will provide you with a brief but...