In last weeks article, I discussed two options for the billing of an orthosis to the insurance carrier, including the Medicare program. Those options were either the applicable L code for the orthosis or CPT code 97760 (orthotic management and training) for patient’s under an outpatient therapy plan of care. In this weeks article, I will discuss what practice settings can bill L codes to the Medicare program for orthotics provided under an outpatient physical or occupational therapy plan of care without requiring a durable medical equipment (DME) supplier number, which practice settings do require a DME supplier number to bill the Medicare program for orthotics using L codes and how to bill orthotics to private insurance carriers, workers compensation programs and state Medicaid programs.
Lets start with the Medicare program. If you are an Outpatient Rehabilitation Facility (Rehab Agency), Comprehensive Outpatient Rehabilitation Facility (CORF), Skilled Nursing Facility (SNF) providing Part B therapy services or an outpatient hospital therapy department, you do
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This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.