Hello Chuck: I should note that AOTA contacted me to check on the status of my appeal. It made me feel 'good' when they called.... <smile>
Ron ----- Original Message ----- From: Charles Willmarth <[EMAIL PROTECTED]> Sent: Friday, December 23, 2005 To: [email protected] <[email protected]> Subj: [OTlist] Florida Medicare Refused to Pay for OT to do Wound Care CW> Great news Ron. >>>> [EMAIL PROTECTED] 12/22/05 8:46 PM >>> CW> Just a quick update. CW> After several denials, an appeal, and multiple e-mails to medical CW> policy, it appears that Florida's fiscal intermediary had a 'coding CW> error' that was preventing OT from being paid for wound care. According CW> to my most recent e-mail from them, the error has been corrected and the CW> claims should start paying. CW> A small victory for OT (the Other Therapy)<smile> CW> Ron CW> ----- Original Message ----- CW> From: Ron Carson <[EMAIL PROTECTED]> CW> Sent: Tuesday, November 08, 2005 CW> To: Charles Willmarth <[email protected]> CW> 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] 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]
