Congrats Ron and thanks for your hard work. Joe ----- Original Message ----- From: "Ron Carson" <[EMAIL PROTECTED]> To: "Ron Carson" <[email protected]> Sent: Thursday, December 22, 2005 8:46 PM Subject: Re: [OTlist] Florida Medicare Refused to Pay for OT to do Wound Care
> Just a quick update. > > After several denials, an appeal, and multiple e-mails to medical > policy, it appears that Florida's fiscal intermediary had a 'coding > error' that was preventing OT from being paid for wound care. According > to my most recent e-mail from them, the error has been corrected and the > claims should start paying. > > A small victory for OT (the Other Therapy)<smile> > > Ron > > ----- Original Message ----- > From: Ron Carson <[EMAIL PROTECTED]> > Sent: Tuesday, November 08, 2005 > To: Charles Willmarth <[email protected]> > Subj: [OTlist] Florida Medicare Refused to Pay for OT to do Wound Care > > RC> You are 100% correct. FCSO's customer service rep read the exact > same > RC> LCD but said they have an INTERNAL document contradicting the LCD. > My > RC> situation was appealed to the Operations Department who feel that > the > RC> internal document (which does not include OT) is correct. > Apparently, > RC> the INTERNAL document is based on a Medical Policy decision > which > RC> specifically states that OT is not reimbursable for wound care. > I've > RC> written Medical Policy but it can take up to 4 weeks to get a reply. > > RC> Chuck, do you know what CMS' policy is on OT and wound care? > > RC> Ron > > RC> ----- Original Message ----- > RC> From: Charles Willmarth <[EMAIL PROTECTED]> > RC> Sent: Tuesday, November 08, 2005 > RC> To: [email protected] <[email protected]> > RC> Subj: [OTlist] Florida Medicare Refused to Pay for OT to do Wound Care > > CW>> Ron, > > CW>> This doesn't make sense; the "FIRST COAST SERVICE OPTIONS > CW>> LOCAL COVERAGE DETERMINATION CODING GUIDELINES" (revised 1/1/05) > state > CW>> that "Active wound care interventions as performend by physical > CW>> therapists, occupational therapists, and enterostomal therapy nurses > are > CW>> reported by means of codes 97597 or 97598 and *97602." > > > CW>> Chuck > > > CW>> **************** > > CW>> > http://www.floridamedicare.com/parta_medcov_local_Debridement%20Services-01.asp > > > CW>> Selective debridement is reported with 97597 or 97598 and > non-selective > CW>> with *97602. The provider performs wound care management to promote > CW>> healing using either selective or non-selective debridement > techniques > CW>> to remove devitalized tissue. Active wound care interventions as > CW>> performend by physical therapists, occupational therapists, and > CW>> enterostomal therapy nurses are reported by means of codes 97597 or > CW>> 97598 and *97602. > >>>>>> [EMAIL PROTECTED] 11/08/05 7:28 AM >>> > CW>> ============== Heads Up ================= > > CW>> After many long conversations with my Medicare fiscal > intermediary > CW>> (First Coast Service Options), they are refusing to pay for active > wound > CW>> care simply because the procedure was provided by an OT. According to > my > CW>> most recent conversations, effective January 1, 2005, wound care is > only > CW>> covered if done by PT, it is not covered if done by OT. I have > written > CW>> to Medical Policy Review but it does not look good. > > CW>> ===================== > > CW>> Ron > > > CW>> -- > CW>> Unsubscribe? > CW>> [EMAIL PROTECTED] > > CW>> Change options? > CW>> www.otnow.com/mailman/options/otlist_otnow.com > > CW>> Archive? > CW>> www.mail-archive.com/[email protected] > > CW>> Help? > CW>> [EMAIL PROTECTED] > > > > > > > -- > Unsubscribe? > [EMAIL PROTECTED] > > Change options? > www.otnow.com/mailman/options/otlist_otnow.com > > Archive? > www.mail-archive.com/[email protected] > > Help? > [EMAIL PROTECTED] > > -- Unsubscribe? [EMAIL PROTECTED] Change options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] Help? [EMAIL PROTECTED]
