Re: L codes for OT splints

> www.cms.hhs.gov/manuals/104_claims/clm104c20.pdf

--- hvilledirector wrote:

> Can anyone give me information regarding L codes for

> OT custom splints?

> Our local CMS FI indicates you must have a DME for

> these codes, but I

> found an article dated 2003 that stated, hospital

> outpt departments do

> not have to worry about being a DME supplier.

> Tim Auwarter

> Director of Rehab Services

> Pardee Hospital

>

> Looking to start and own 100% of your own Practice?

>

> Visit www.InHomeRehab.com.

> PTManager encourages participation in your

> professional association. Join and participate now!

>

October 31, 2005

Can some one recommend the appropriate billing code for OP PT for Interferential

E- Stim to a shoulder or LB? Or for just E Etim 2 electrodes to a shoulder or

LB?

October 31, 2005

Can some one recommend the appropriate billing code for OP PT for Interferential

E- Stim to a shoulder or LB? Or for just E Etim 2 electrodes to a shoulder or

LB?

November 1, 2005

Rick,

Thanks for the information. We are an outpatient clinic that is based

with the hospital. This has been hard to find information. We have

a new chargemaster person and they called Palmetto GBA and were told

no you can't bill DME without a license. Now we can reference their

own material. Do you have any additional information for using

these codes? I am thinking they need to be attached to a bill with a

CPT procedure code, is that correct? - Tim

-- In PTManager , Rick Gawenda <rick0905@y...> wrote:

>

> Tim,

>

> If you are a hospital outpatient department, CORF, SNF

> Part B, or rehab agency, you can bill L codes to your

> Medicare FI without needing a DME license. Here is the

> reference. Read page 6.

>

>

> Call if questions.

>

> Rick Gawenda, PT

> Director PM & R

> Detroit Receiving Hospital

>

> --- hvilledirector <hvilledirector@y...> wrote:

>

> > Can anyone give me information regarding L codes for

> > OT custom splints?

> > Our local CMS FI indicates you must have a DME for

> > these codes, but I

> > found an article dated 2003 that stated, hospital

> > outpt departments do

> > not have to worry about being a DME supplier.

> > Tim Auwarter

> > Director of Rehab Services

> > Pardee Hospital

> >

> > Looking to start and own 100% of your own Practice?

> >

> > Visit www.InHomeRehab.com.

> > PTManager encourages participation in your

> > professional association. Join and participate now!

> >

November 1, 2005

Tim,

The L code is for the assessment, fabrication time and

the supplies. If your therapist trains the patient in

the use of the orthotic, you can bill the appropriate

number of units of 97504 based on the time spent. If

other treatment was also provided, the appropriate

number of units of those modalities/procedures would

also be billed. This would all be billed on the UB-92

claim form. Hope this answers your question.

Rick Gawenda, PT

Director PM & R

Detroit Receiving Hospital

> > www.cms.hhs.gov/manuals/104_claims/clm104c20.pdf

--- hvilledirector wrote:

> Rick,

> Thanks for the information. We are an outpatient

> clinic that is based

> with the hospital. This has been hard to find

> information. We have

> a new chargemaster person and they called Palmetto

> GBA and were told

> no you can't bill DME without a license. Now we can

> reference their

> own material. Do you have any additional

> information for using

> these codes? I am thinking they need to be attached

> to a bill with a

> CPT procedure code, is that correct? - Tim

> -- In PTManager , Rick Gawenda

> <rick0905@y...> wrote:

> >

> > Tim,

> >

> > If you are a hospital outpatient department, CORF,

> SNF

> > Part B, or rehab agency, you can bill L codes to

> your

> > Medicare FI without needing a DME license. Here is

> the

> > reference. Read page 6.

> >

> >

> > Call if questions.

> >

> > Rick Gawenda, PT

> > Director PM & R

> > Detroit Receiving Hospital

> >

> > --- hvilledirector <hvilledirector@y...> wrote:

> >

> > > Can anyone give me information regarding L codes

> for

> > > OT custom splints?

> > > Our local CMS FI indicates you must have a DME

> for

> > > these codes, but I

> > > found an article dated 2003 that stated,

> hospital

> > > outpt departments do

> > > not have to worry about being a DME supplier.

> > > Tim Auwarter

> > > Director of Rehab Services

> > > Pardee Hospital

> > >

> > > Looking to start and own 100% of your own

> Practice?

> > >

> > > Visit www.InHomeRehab.com.

> > > PTManager encourages participation in your

> > > professional association. Join and participate

> now!

> > >

November 1, 2005

Tim,

The L code is for the assessment, fabrication time and

the supplies. If your therapist trains the patient in

the use of the orthotic, you can bill the appropriate

number of units of 97504 based on the time spent. If

other treatment was also provided, the appropriate

number of units of those modalities/procedures would

also be billed. This would all be billed on the UB-92

claim form. Hope this answers your question.

Rick Gawenda, PT

Director PM & R

Detroit Receiving Hospital

> > www.cms.hhs.gov/manuals/104_claims/clm104c20.pdf

--- hvilledirector wrote:

> Rick,

> Thanks for the information. We are an outpatient

> clinic that is based

> with the hospital. This has been hard to find

> information. We have

> a new chargemaster person and they called Palmetto

> GBA and were told

> no you can't bill DME without a license. Now we can

> reference their

> own material. Do you have any additional

> information for using

> these codes? I am thinking they need to be attached

> to a bill with a

> CPT procedure code, is that correct? - Tim

> -- In PTManager , Rick Gawenda

> <rick0905@y...> wrote:

> >

> > Tim,

> >

> > If you are a hospital outpatient department, CORF,

> SNF

> > Part B, or rehab agency, you can bill L codes to

> your

> > Medicare FI without needing a DME license. Here is

> the

> > reference. Read page 6.

> >

> >

> > Call if questions.

> >

> > Rick Gawenda, PT

> > Director PM & R

> > Detroit Receiving Hospital

> >

> > --- hvilledirector <hvilledirector@y...> wrote:

> >

> > > Can anyone give me information regarding L codes

> for

> > > OT custom splints?

> > > Our local CMS FI indicates you must have a DME

> for

> > > these codes, but I

> > > found an article dated 2003 that stated,

> hospital

> > > outpt departments do

> > > not have to worry about being a DME supplier.

> > > Tim Auwarter

> > > Director of Rehab Services

> > > Pardee Hospital

> > >

> > > Looking to start and own 100% of your own

> Practice?

> > >

> > > Visit www.InHomeRehab.com.

> > > PTManager encourages participation in your

> > > professional association. Join and participate

> now!

> > >

November 1, 2005

Tim,

The L code is for the assessment, fabrication time and

the supplies. If your therapist trains the patient in

the use of the orthotic, you can bill the appropriate

number of units of 97504 based on the time spent. If

other treatment was also provided, the appropriate

number of units of those modalities/procedures would

also be billed. This would all be billed on the UB-92

claim form. Hope this answers your question.

Rick Gawenda, PT

Director PM & R

Detroit Receiving Hospital

> > www.cms.hhs.gov/manuals/104_claims/clm104c20.pdf

--- hvilledirector wrote:

> Rick,

> Thanks for the information. We are an outpatient

> clinic that is based

> with the hospital. This has been hard to find

> information. We have

> a new chargemaster person and they called Palmetto

> GBA and were told

> no you can't bill DME without a license. Now we can

> reference their

> own material. Do you have any additional

> information for using

> these codes? I am thinking they need to be attached

> to a bill with a

> CPT procedure code, is that correct? - Tim

> -- In PTManager , Rick Gawenda

> <rick0905@y...> wrote:

> >

> > Tim,

> >

> > If you are a hospital outpatient department, CORF,

> SNF

> > Part B, or rehab agency, you can bill L codes to

> your

> > Medicare FI without needing a DME license. Here is

> the

> > reference. Read page 6.

> >

> >

> > Call if questions.

> >

> > Rick Gawenda, PT

> > Director PM & R

> > Detroit Receiving Hospital

> >

> > --- hvilledirector <hvilledirector@y...> wrote:

> >

> > > Can anyone give me information regarding L codes

> for

> > > OT custom splints?

> > > Our local CMS FI indicates you must have a DME

> for

> > > these codes, but I

> > > found an article dated 2003 that stated,

> hospital

> > > outpt departments do

> > > not have to worry about being a DME supplier.

> > > Tim Auwarter

> > > Director of Rehab Services

> > > Pardee Hospital

> > >

> > > Looking to start and own 100% of your own

> Practice?

> > >

> > > Visit www.InHomeRehab.com.

> > > PTManager encourages participation in your

> > > professional association. Join and participate

> now!

> > >

November 2, 2005

I believe that your organization needs a DME license to bill L codes.

Terry Rose PT,MS

Director Of Rehab Services

Niagara Falls Memorial Medical Center

Re: Re: L codes for OT splints

Tim,

The L code is for the assessment, fabrication time and

the supplies. If your therapist trains the patient in

the use of the orthotic, you can bill the appropriate

number of units of 97504 based on the time spent. If

other treatment was also provided, the appropriate

number of units of those modalities/procedures would

also be billed. This would all be billed on the UB-92

claim form. Hope this answers your question.

Rick Gawenda, PT

Director PM & R

Detroit Receiving Hospital

> > www.cms.hhs.gov/manuals/104_claims/clm104c20.pdf

--- hvilledirector wrote:

> Rick,

> Thanks for the information. We are an outpatient

> clinic that is based

> with the hospital. This has been hard to find

> information. We have

> a new chargemaster person and they called Palmetto

> GBA and were told

> no you can't bill DME without a license. Now we can

> reference their

> own material. Do you have any additional

> information for using

> these codes? I am thinking they need to be attached

> to a bill with a

> CPT procedure code, is that correct? - Tim

> -- In PTManager , Rick Gawenda

> <rick0905@y...> wrote:

> >

> > Tim,

> >

> > If you are a hospital outpatient department, CORF,

> SNF

> > Part B, or rehab agency, you can bill L codes to

> your

> > Medicare FI without needing a DME license. Here is

> the

> > reference. Read page 6.

> >

> >

> > Call if questions.

> >

> > Rick Gawenda, PT

> > Director PM & R

> > Detroit Receiving Hospital

> >

> > --- hvilledirector <hvilledirector@y...> wrote:

> >

> > > Can anyone give me information regarding L codes

> for

> > > OT custom splints?

> > > Our local CMS FI indicates you must have a DME

> for

> > > these codes, but I

> > > found an article dated 2003 that stated,

> hospital

> > > outpt departments do

> > > not have to worry about being a DME supplier.

> > > Tim Auwarter

> > > Director of Rehab Services

> > > Pardee Hospital

> > >

> > > Looking to start and own 100% of your own

> Practice?

> > >

> > > Visit www.InHomeRehab.com.

> > > PTManager encourages participation in your

> > > professional association. Join and participate

> now!

> > >

November 2, 2005

I believe that your organization needs a DME license to bill L codes.

Terry Rose PT,MS

Director Of Rehab Services

Niagara Falls Memorial Medical Center

Re: Re: L codes for OT splints

Tim,

The L code is for the assessment, fabrication time and

the supplies. If your therapist trains the patient in

the use of the orthotic, you can bill the appropriate

number of units of 97504 based on the time spent. If

other treatment was also provided, the appropriate

number of units of those modalities/procedures would

also be billed. This would all be billed on the UB-92

claim form. Hope this answers your question.

Rick Gawenda, PT

Director PM & R

Detroit Receiving Hospital

> > www.cms.hhs.gov/manuals/104_claims/clm104c20.pdf

--- hvilledirector wrote:

> Rick,

> Thanks for the information. We are an outpatient

> clinic that is based

> with the hospital. This has been hard to find

> information. We have

> a new chargemaster person and they called Palmetto

> GBA and were told

> no you can't bill DME without a license. Now we can

> reference their

> own material. Do you have any additional

> information for using

> these codes? I am thinking they need to be attached

> to a bill with a

> CPT procedure code, is that correct? - Tim

> -- In PTManager , Rick Gawenda

> <rick0905@y...> wrote:

> >

> > Tim,

> >

> > If you are a hospital outpatient department, CORF,

> SNF

> > Part B, or rehab agency, you can bill L codes to

> your

> > Medicare FI without needing a DME license. Here is

> the

> > reference. Read page 6.

> >

> >

> > Call if questions.

> >

> > Rick Gawenda, PT

> > Director PM & R

> > Detroit Receiving Hospital

> >

> > --- hvilledirector <hvilledirector@y...> wrote:

> >

> > > Can anyone give me information regarding L codes

> for

> > > OT custom splints?

> > > Our local CMS FI indicates you must have a DME

> for

> > > these codes, but I

> > > found an article dated 2003 that stated,

> hospital

> > > outpt departments do

> > > not have to worry about being a DME supplier.

> > > Tim Auwarter

> > > Director of Rehab Services

> > > Pardee Hospital

> > >

> > > Looking to start and own 100% of your own

> Practice?

> > >

> > > Visit www.InHomeRehab.com.

> > > PTManager encourages participation in your

> > > professional association. Join and participate

> now!

> > >

November 2, 2005

I believe that your organization needs a DME license to bill L codes.

Terry Rose PT,MS

Director Of Rehab Services

Niagara Falls Memorial Medical Center

Re: Re: L codes for OT splints

Tim,

The L code is for the assessment, fabrication time and

the supplies. If your therapist trains the patient in

the use of the orthotic, you can bill the appropriate

number of units of 97504 based on the time spent. If

other treatment was also provided, the appropriate

number of units of those modalities/procedures would

also be billed. This would all be billed on the UB-92

claim form. Hope this answers your question.

Rick Gawenda, PT

Director PM & R

Detroit Receiving Hospital

> > www.cms.hhs.gov/manuals/104_claims/clm104c20.pdf

--- hvilledirector wrote:

> Rick,

> Thanks for the information. We are an outpatient

> clinic that is based

> with the hospital. This has been hard to find

> information. We have

> a new chargemaster person and they called Palmetto

> GBA and were told

> no you can't bill DME without a license. Now we can

> reference their

> own material. Do you have any additional

> information for using

> these codes? I am thinking they need to be attached

> to a bill with a

> CPT procedure code, is that correct? - Tim

> -- In PTManager , Rick Gawenda

> <rick0905@y...> wrote:

> >

> > Tim,

> >

> > If you are a hospital outpatient department, CORF,

> SNF

> > Part B, or rehab agency, you can bill L codes to

> your

> > Medicare FI without needing a DME license. Here is

> the

> > reference. Read page 6.

> >

> >

> > Call if questions.

> >

> > Rick Gawenda, PT

> > Director PM & R

> > Detroit Receiving Hospital

> >

> > --- hvilledirector <hvilledirector@y...> wrote:

> >

> > > Can anyone give me information regarding L codes

> for

> > > OT custom splints?

> > > Our local CMS FI indicates you must have a DME

> for

> > > these codes, but I

> > > found an article dated 2003 that stated,

> hospital

> > > outpt departments do

> > > not have to worry about being a DME supplier.

> > > Tim Auwarter

> > > Director of Rehab Services

> > > Pardee Hospital

> > >

> > > Looking to start and own 100% of your own

> Practice?

> > >

> > > Visit www.InHomeRehab.com.

> > > PTManager encourages participation in your

> > > professional association. Join and participate

> now!

> > >

November 2, 2005

Terry/Rick,

Here in lies the original question, does an outpt department of the

hospital need a DME to bill the L codes?

Rick,

I am sharing information with our chargemaster person, who still has

questions about where to find this information. Do you have a

specific section in the cms document that you were referring to in

previous email. We were looking at using the 3701 - 3985 codes, but

according the local FI website, those are not included in what is

covered. Any additional thoughts? - Tim

> > >

> > > > Can anyone give me information regarding L codes

> > for

> > > > OT custom splints?

> > > > Our local CMS FI indicates you must have a DME

> > for

> > > > these codes, but I

> > > > found an article dated 2003 that stated,

> > hospital

> > > > outpt departments do

> > > > not have to worry about being a DME supplier.

> > > > Tim Auwarter

> > > > Director of Rehab Services

> > > > Pardee Hospital

> > > >

> > > > Looking to start and own 100% of your own

> > Practice?

> > > >

> > > > Visit www.InHomeRehab.com.

> > > > PTManager encourages participation in your

> > > > professional association. Join and participate

> > now!

> > > >

November 2, 2005

Terry/Rick,

Here in lies the original question, does an outpt department of the

hospital need a DME to bill the L codes?

Rick,

I am sharing information with our chargemaster person, who still has

questions about where to find this information. Do you have a

specific section in the cms document that you were referring to in

previous email. We were looking at using the 3701 - 3985 codes, but

according the local FI website, those are not included in what is

covered. Any additional thoughts? - Tim

> > >

> > > > Can anyone give me information regarding L codes

> > for

> > > > OT custom splints?

> > > > Our local CMS FI indicates you must have a DME

> > for

> > > > these codes, but I

> > > > found an article dated 2003 that stated,

> > hospital

> > > > outpt departments do

> > > > not have to worry about being a DME supplier.

> > > > Tim Auwarter

> > > > Director of Rehab Services

> > > > Pardee Hospital

> > > >

> > > > Looking to start and own 100% of your own

> > Practice?

> > > >

> > > > Visit www.InHomeRehab.com.

> > > > PTManager encourages participation in your

> > > > professional association. Join and participate

> > now!

> > > >

November 2, 2005

Terry/Rick,

Here in lies the original question, does an outpt department of the

hospital need a DME to bill the L codes?

Rick,

I am sharing information with our chargemaster person, who still has

questions about where to find this information. Do you have a

specific section in the cms document that you were referring to in

previous email. We were looking at using the 3701 - 3985 codes, but

according the local FI website, those are not included in what is

covered. Any additional thoughts? - Tim

> > >

> > > > Can anyone give me information regarding L codes

> > for

> > > > OT custom splints?

> > > > Our local CMS FI indicates you must have a DME

> > for

> > > > these codes, but I

> > > > found an article dated 2003 that stated,

> > hospital

> > > > outpt departments do

> > > > not have to worry about being a DME supplier.

> > > > Tim Auwarter

> > > > Director of Rehab Services

> > > > Pardee Hospital

> > > >

> > > > Looking to start and own 100% of your own

> > Practice?

> > > >

> > > > Visit www.InHomeRehab.com.

> > > > PTManager encourages participation in your

> > > > professional association. Join and participate

> > now!

> > > >

November 2, 2005

Terry,

Please go to the link I provided in the e-mail below.

Those settings do not need a DME license to bill their

Medicare FI for orthotics. If you are private

practice, you would need one. The reference is an

excellent resource.

Rick gawenda, PT

Director PM & R

Detroit Receiving Hospital

--- " Rose, Terry " wrote:

> I believe that your organization needs a DME license

> to bill L codes.

>

> Terry Rose PT,MS

> Director Of Rehab Services

> Niagara Falls Memorial Medical Center

>

> Re: Re: L codes for OT splints

>

> Tim,

>

> The L code is for the assessment, fabrication time

> and

> the supplies. If your therapist trains the patient

> in

> the use of the orthotic, you can bill the

> appropriate

> number of units of 97504 based on the time spent. If

> other treatment was also provided, the appropriate

> number of units of those modalities/procedures would

> also be billed. This would all be billed on the

> UB-92

> claim form. Hope this answers your question.

>

> Rick Gawenda, PT

> Director PM & R

> Detroit Receiving Hospital

>

> --- hvilledirector wrote:

>

> > Rick,

> > Thanks for the information. We are an outpatient

> > clinic that is based

> > with the hospital. This has been hard to find

> > information. We have

> > a new chargemaster person and they called Palmetto

> > GBA and were told

> > no you can't bill DME without a license. Now we

> can

> > reference their

> > own material. Do you have any additional

> > information for using

> > these codes? I am thinking they need to be

> attached

> > to a bill with a

> > CPT procedure code, is that correct? - Tim

> > -- In PTManager , Rick Gawenda

> > <rick0905@y...> wrote:

> > >

> > > Tim,

> > >

> > > If you are a hospital outpatient department,

> CORF,

> > SNF

> > > Part B, or rehab agency, you can bill L codes to

> > your

> > > Medicare FI without needing a DME license. Here

> is

> > the

> > > reference. Read page 6.

> > >

> > > www.cms.hhs.gov/manuals/104_claims/clm104c20.pdf

> > >

> > > Call if questions.

> > >

> > > Rick Gawenda, PT

> > > Director PM & R

> > > Detroit Receiving Hospital

> > > www.gawendaseminars.com

> > >

> > > --- hvilledirector <hvilledirector@y...> wrote:

> > >

> > > > Can anyone give me information regarding L

> codes

> > for

> > > > OT custom splints?

> > > > Our local CMS FI indicates you must have a DME

> > for

> > > > these codes, but I

> > > > found an article dated 2003 that stated,

> > hospital

> > > > outpt departments do

> > > > not have to worry about being a DME supplier.

> > > > Tim Auwarter

> > > > Director of Rehab Services

> > > > Pardee Hospital

> > > >

> > > > Looking to start and own 100% of your own

> > Practice?

> > > >

> > > > Visit www.InHomeRehab.com.

> > > > PTManager encourages participation in your

> > > > professional association. Join and

> participate

> > now!

> > > >

November 2, 2005

Terry,

Please go to the link I provided in the e-mail below.

Those settings do not need a DME license to bill their

Medicare FI for orthotics. If you are private

practice, you would need one. The reference is an

excellent resource.

Rick gawenda, PT

Director PM & R

Detroit Receiving Hospital

--- " Rose, Terry " wrote:

> I believe that your organization needs a DME license

> to bill L codes.

>

> Terry Rose PT,MS

> Director Of Rehab Services

> Niagara Falls Memorial Medical Center

>

> Re: Re: L codes for OT splints

>

> Tim,

>

> The L code is for the assessment, fabrication time

> and

> the supplies. If your therapist trains the patient

> in

> the use of the orthotic, you can bill the

> appropriate

> number of units of 97504 based on the time spent. If

> other treatment was also provided, the appropriate

> number of units of those modalities/procedures would

> also be billed. This would all be billed on the

> UB-92

> claim form. Hope this answers your question.

>

> Rick Gawenda, PT

> Director PM & R

> Detroit Receiving Hospital

>

> --- hvilledirector wrote:

>

> > Rick,

> > Thanks for the information. We are an outpatient

> > clinic that is based

> > with the hospital. This has been hard to find

> > information. We have

> > a new chargemaster person and they called Palmetto

> > GBA and were told

> > no you can't bill DME without a license. Now we

> can

> > reference their

> > own material. Do you have any additional

> > information for using

> > these codes? I am thinking they need to be

> attached

> > to a bill with a

> > CPT procedure code, is that correct? - Tim

> > -- In PTManager , Rick Gawenda

> > <rick0905@y...> wrote:

> > >

> > > Tim,

> > >

> > > If you are a hospital outpatient department,

> CORF,

> > SNF

> > > Part B, or rehab agency, you can bill L codes to

> > your

> > > Medicare FI without needing a DME license. Here

> is

> > the

> > > reference. Read page 6.

> > >

> > > www.cms.hhs.gov/manuals/104_claims/clm104c20.pdf

> > >

> > > Call if questions.

> > >

> > > Rick Gawenda, PT

> > > Director PM & R

> > > Detroit Receiving Hospital

> > > www.gawendaseminars.com

> > >

> > > --- hvilledirector <hvilledirector@y...> wrote:

> > >

> > > > Can anyone give me information regarding L

> codes

> > for

> > > > OT custom splints?

> > > > Our local CMS FI indicates you must have a DME

> > for

> > > > these codes, but I

> > > > found an article dated 2003 that stated,

> > hospital

> > > > outpt departments do

> > > > not have to worry about being a DME supplier.

> > > > Tim Auwarter

> > > > Director of Rehab Services

> > > > Pardee Hospital

> > > >

> > > > Looking to start and own 100% of your own

> > Practice?

> > > >

> > > > Visit www.InHomeRehab.com.

> > > > PTManager encourages participation in your

> > > > professional association. Join and

> participate

> > now!

> > > >

November 2, 2005

Terry,

Please go to the link I provided in the e-mail below.

Those settings do not need a DME license to bill their

Medicare FI for orthotics. If you are private

practice, you would need one. The reference is an

excellent resource.

Rick gawenda, PT

Director PM & R

Detroit Receiving Hospital

--- " Rose, Terry " wrote:

> I believe that your organization needs a DME license

> to bill L codes.

>

> Terry Rose PT,MS

> Director Of Rehab Services

> Niagara Falls Memorial Medical Center

>

> Re: Re: L codes for OT splints

>

> Tim,

>

> The L code is for the assessment, fabrication time

> and

> the supplies. If your therapist trains the patient

> in

> the use of the orthotic, you can bill the

> appropriate

> number of units of 97504 based on the time spent. If

> other treatment was also provided, the appropriate

> number of units of those modalities/procedures would

> also be billed. This would all be billed on the

> UB-92

> claim form. Hope this answers your question.

>

> Rick Gawenda, PT

> Director PM & R

> Detroit Receiving Hospital

>

> --- hvilledirector wrote:

>

> > Rick,

> > Thanks for the information. We are an outpatient

> > clinic that is based

> > with the hospital. This has been hard to find

> > information. We have

> > a new chargemaster person and they called Palmetto

> > GBA and were told

> > no you can't bill DME without a license. Now we

> can

> > reference their

> > own material. Do you have any additional

> > information for using

> > these codes? I am thinking they need to be

> attached

> > to a bill with a

> > CPT procedure code, is that correct? - Tim

> > -- In PTManager , Rick Gawenda

> > <rick0905@y...> wrote:

> > >

> > > Tim,

> > >

> > > If you are a hospital outpatient department,

> CORF,

> > SNF

> > > Part B, or rehab agency, you can bill L codes to

> > your

> > > Medicare FI without needing a DME license. Here

> is

> > the

> > > reference. Read page 6.

> > >

> > > www.cms.hhs.gov/manuals/104_claims/clm104c20.pdf

> > >

> > > Call if questions.

> > >

> > > Rick Gawenda, PT

> > > Director PM & R

> > > Detroit Receiving Hospital

> > > www.gawendaseminars.com

> > >

> > > --- hvilledirector <hvilledirector@y...> wrote:

> > >

> > > > Can anyone give me information regarding L

> codes

> > for

> > > > OT custom splints?

> > > > Our local CMS FI indicates you must have a DME

> > for

> > > > these codes, but I

> > > > found an article dated 2003 that stated,

> > hospital

> > > > outpt departments do

> > > > not have to worry about being a DME supplier.

> > > > Tim Auwarter

> > > > Director of Rehab Services

> > > > Pardee Hospital

> > > >

> > > > Looking to start and own 100% of your own

> > Practice?

> > > >

> > > > Visit www.InHomeRehab.com.

> > > > PTManager encourages participation in your

> > > > professional association. Join and

> participate

> > now!

> > > >

November 2, 2005

You DO NOT need a DME license to bill Medicare for orthotics and

prosthetics. For patients receiving splints from hospital OP, SNF part B,

CORF, and rehabilitation facilities bills should be billed on the CMS be

forms to the providers intermediary using the Medicare alpha-numeric Level

II HCPCS codes (L-codes).

We have been billing our FI for L-codes for both PT and OT and have not had

any problems with reimbursement

Ann Heiman

Director of Rehab Services

Spencer Hospital

Spencer, IA

the splint to the patient, the orthotics fitting and training code

Re: Re: L codes for OT splints

Tim,

for the assessment, fabrication time and

the supplies. If your therapist trains the patient in

the use of the orthotic, you can bill the appropriate

number of units of 97504 based on the time spent. If

other treatment was also provided, the appropriate

number of units of those modalities/procedures would

also be billed. This would all be billed on the UB-92

claim form. Hope this answers your question.

Rick Gawenda, PT

Director PM & R

Detroit Receiving Hospital

> > www.cms.hhs.gov/manuals/104_claims/clm104c20.pdf

--- hvilledirector wrote:

> Rick,

> Thanks for the information. We are an outpatient

> clinic that is based

> with the hospital. This has been hard to find

> information. We have

> a new chargemaster person and they called Palmetto

> GBA and were told

> no you can't bill DME without a license. Now we can

> reference their

> own material. Do you have any additional

> information for using

> these codes? I am thinking they need to be attached

> to a bill with a

> CPT procedure code, is that correct? - Tim

> -- In PTManager , Rick Gawenda

> <rick0905@y...> wrote:

> >

> > Tim,

> >

> > If you are a hospital outpatient department, CORF,

> SNF

> > Part B, or rehab agency, you can bill L codes to

> your

> > Medicare FI without needing a DME license. Here is

> the

> > reference. Read page 6.

> >

> >

> > Call if questions.

> >

> > Rick Gawenda, PT

> > Director PM & R

> > Detroit Receiving Hospital

> >

> > --- hvilledirector <hvilledirector@y...> wrote:

> >

> > > Can anyone give me information regarding L codes

> for

> > > OT custom splints?

> > > Our local CMS FI indicates you must have a DME

> for

> > > these codes, but I

> > > found an article dated 2003 that stated,

> hospital

> > > outpt departments do

> > > not have to worry about being a DME supplier.

> > > Tim Auwarter

> > > Director of Rehab Services

> > > Pardee Hospital

> > >

> > > Looking to start and own 100% of your own

> Practice?

> > >

> > > Visit www.InHomeRehab.com.

> > > PTManager encourages participation in your

> > > professional association. Join and participate

> now!

> > >

November 2, 2005

You DO NOT need a DME license to bill Medicare for orthotics and

prosthetics. For patients receiving splints from hospital OP, SNF part B,

CORF, and rehabilitation facilities bills should be billed on the CMS be

forms to the providers intermediary using the Medicare alpha-numeric Level

II HCPCS codes (L-codes).

We have been billing our FI for L-codes for both PT and OT and have not had

any problems with reimbursement

Ann Heiman

Director of Rehab Services

Spencer Hospital

Spencer, IA

the splint to the patient, the orthotics fitting and training code

Re: Re: L codes for OT splints

Tim,

for the assessment, fabrication time and

the supplies. If your therapist trains the patient in

the use of the orthotic, you can bill the appropriate

number of units of 97504 based on the time spent. If

other treatment was also provided, the appropriate

number of units of those modalities/procedures would

also be billed. This would all be billed on the UB-92

claim form. Hope this answers your question.

Rick Gawenda, PT

Director PM & R

Detroit Receiving Hospital

> > www.cms.hhs.gov/manuals/104_claims/clm104c20.pdf

--- hvilledirector wrote:

> Rick,

> Thanks for the information. We are an outpatient

> clinic that is based

> with the hospital. This has been hard to find

> information. We have

> a new chargemaster person and they called Palmetto

> GBA and were told

> no you can't bill DME without a license. Now we can

> reference their

> own material. Do you have any additional

> information for using

> these codes? I am thinking they need to be attached

> to a bill with a

> CPT procedure code, is that correct? - Tim

> -- In PTManager , Rick Gawenda

> <rick0905@y...> wrote:

> >

> > Tim,

> >

> > If you are a hospital outpatient department, CORF,

> SNF

> > Part B, or rehab agency, you can bill L codes to

> your

> > Medicare FI without needing a DME license. Here is

> the

> > reference. Read page 6.

> >

> >

> > Call if questions.

> >

> > Rick Gawenda, PT

> > Director PM & R

> > Detroit Receiving Hospital

> >

> > --- hvilledirector <hvilledirector@y...> wrote:

> >

> > > Can anyone give me information regarding L codes

> for

> > > OT custom splints?

> > > Our local CMS FI indicates you must have a DME

> for

> > > these codes, but I

> > > found an article dated 2003 that stated,

> hospital

> > > outpt departments do

> > > not have to worry about being a DME supplier.

> > > Tim Auwarter

> > > Director of Rehab Services

> > > Pardee Hospital

> > >

> > > Looking to start and own 100% of your own

> Practice?

> > >

> > > Visit www.InHomeRehab.com.

> > > PTManager encourages participation in your

> > > professional association. Join and participate

> now!

> > >

November 2, 2005

You DO NOT need a DME license to bill Medicare for orthotics and

prosthetics. For patients receiving splints from hospital OP, SNF part B,

CORF, and rehabilitation facilities bills should be billed on the CMS be

forms to the providers intermediary using the Medicare alpha-numeric Level

II HCPCS codes (L-codes).

We have been billing our FI for L-codes for both PT and OT and have not had

any problems with reimbursement

Ann Heiman

Director of Rehab Services

Spencer Hospital

Spencer, IA

the splint to the patient, the orthotics fitting and training code

Re: Re: L codes for OT splints

Tim,

for the assessment, fabrication time and

the supplies. If your therapist trains the patient in

the use of the orthotic, you can bill the appropriate

number of units of 97504 based on the time spent. If

other treatment was also provided, the appropriate

number of units of those modalities/procedures would

also be billed. This would all be billed on the UB-92

claim form. Hope this answers your question.

Rick Gawenda, PT

Director PM & R

Detroit Receiving Hospital

> > www.cms.hhs.gov/manuals/104_claims/clm104c20.pdf

--- hvilledirector wrote:

> Rick,

> Thanks for the information. We are an outpatient

> clinic that is based

> with the hospital. This has been hard to find

> information. We have

> a new chargemaster person and they called Palmetto

> GBA and were told

> no you can't bill DME without a license. Now we can

> reference their

> own material. Do you have any additional

> information for using

> these codes? I am thinking they need to be attached

> to a bill with a

> CPT procedure code, is that correct? - Tim

> -- In PTManager , Rick Gawenda

> <rick0905@y...> wrote:

> >

> > Tim,

> >

> > If you are a hospital outpatient department, CORF,

> SNF

> > Part B, or rehab agency, you can bill L codes to

> your

> > Medicare FI without needing a DME license. Here is

> the

> > reference. Read page 6.

> >

> >

> > Call if questions.

> >

> > Rick Gawenda, PT

> > Director PM & R

> > Detroit Receiving Hospital