Coding Disclaimers

Coding Disclaimers

Coding Disclaimers

PDAC Validation

Suggested HCPCS Codes

The responsibility for accurate coding lies with the patient care facility that selects the product, fits the patient, and bills for the service.

The product/device “Supplier” (defined as an O&P practitioner, O&P patient care facility, Podiatrist, Orthopedist, Physical therapist or DME Supplier) assumes full responsibility for accurate billing of KevinRoot Medical products. It is the Supplier’s responsibility to determine medical necessity; ensure coverage criteria is met; and submit appropriate HCPCS codes, modifiers, and charges for services/products delivered. It is also recommended that Supplier’s contact insurance payer(s) for coding and coverage guidance prior to submitting claims. KevinRoot Medical Coding Suggestions and Reimbursement Guides are based on reasonable judgment and are not recommended to replace the Supplier’s judgment. These recommendations may be subject to revision based on additional information or alpha-numeric system changes.

PDAC Coding Verifications

The Medicare Pricing Data, Analysis and Coding (PDAC) group conducts coding reviews on durable medical equipment, orthotics, prosthetics and supplies (DEMPOS). The coding verification process is voluntary, except when mandated by Medicare for billing purposes. To see the DEMPOS Product Classification List, visit dmepdac.com.

The assignment of the HCPCS codes in these letters is not an approval or endorsement of the products by Medicare or the PDAC contractor, nor does it imply or guarantee claim reimbursement or coverage. Always refer to the specific Local Coverage Determination (LCD) or Policy Article for correct billing instructions.

Suggested HCPCS Codes

The responsibility for accurate coding lies with the patient care facility that selects the product, fits the patient, and bills for the service.

The product/device “Supplier” (defined as an O&P practitioner, O&P patient care facility, Podiatrist, Orthopedist, Physical therapist or DME Supplier) assumes full responsibility for accurate billing of KevinRoot Medical products. It is the Supplier’s responsibility to determine medical necessity; ensure coverage criteria is met; and submit appropriate HCPCS codes, modifiers, and charges for services/products delivered. It is also recommended that Supplier’s contact insurance payer(s) for coding and coverage guidance prior to submitting claims. KevinRoot Medical Coding Suggestions and Reimbursement Guides are based on reasonable judgment and are not recommended to replace the Supplier’s judgment. These recommendations may be subject to revision based on additional information or alpha-numeric system changes.

PDAC Coding Verifications

The Medicare Pricing Data, Analysis and Coding (PDAC) group conducts coding reviews on durable medical equipment, orthotics, prosthetics and supplies (DEMPOS). The coding verification process is voluntary, except when mandated by Medicare for billing purposes. To see the DEMPOS Product Classification List, visit dmepdac.com.

The assignment of the HCPCS codes in these letters is not an approval or endorsement of the products by Medicare or the PDAC contractor, nor does it imply or guarantee claim reimbursement or coverage. Always refer to the specific Local Coverage Determination (LCD) or Policy Article for correct billing instructions.

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KevinRoot Medical Team