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Hi Jodi:
I am thinking this a carrier specific issue. My splints have been covered
fine in nursing homes. But got denied at my private practice with the carrier
(PGBA) for Ohio. Please let me know, if you are using the "L" code HCPCS or, the
29_ _ _ series for the splints. The "L" codes are the usual way nursing homes
and DMEPOS companies bill. I and my group were billing the 29_____ series as
"application of ____ splints" under therapies. So, I am now thinking it must
have something to do with those. There is nothing in the LMRPs regarding
this.
Joe
----- Original Message -----
Sent: Saturday, October 11, 2003 12:00
PM
Subject: Re: [OTlist] Medicare cap and
splint reimbursements in MD
I am in nursing home and home health. In Nursing home
I am using 97504 for OT service related to splints and Hic Pic
codes ( I don's have my catalog here ) for splints. In home health we
use D9 Orthotics for the service and HicPic codes for the splint. I am
in Mississippi and Cahaba is my intermediary in the nursing home and Palmetto
is my intermediary for home health. I havent heard yet of any claims
being denied but I am not sure that they have already been paid. --
Jody
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