All You Want To Know About Custom Orthotics Billing - PowerPoint PPT Presentation

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All You Want To Know About Custom Orthotics Billing


Custom orthotics insurance coverage varies by an insurance company. Click here to know everything about custom orthotics billing. – PowerPoint PPT presentation

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Date added: 29 August 2022
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Title: All You Want To Know About Custom Orthotics Billing

All You Want to Know About Custom Orthotics
Most providers involved in the field of orthotics
and prosthetics are concerned about billing for
orthoses. This is especially true for OP
providers because the burden of getting paid for
services rendered frequently falls squarely on
their shoulders. Such concerns would not have
existed in a cash-only practice. But that is not
the case. A modern practice must recoup costs
from the patient's insurance provider. This
includes preparing and submitting a formal claim
for reimbursement. Thats why it is crucial to
know everything about custom orthotics billing.
Here is a glimpse of the orthotics and
prosthetics providers Read more
All You Want to Know About Custom Orthotics
Custom Foot Orthotics Insurance Coverage
  • CPT CODE 97760 - Examination, Designing,
    Casting, and Education
  • HCPCS CODE L3000 - Foot, removable insert, molded
    to patient model, 'UCB' type.
  • HCPCS CODE L3030 - Foot, removable insert, formed
    to patient foot, each
  • (MODIFIER Left and Right Foot will be billed
    separately i.e., L3030RT for the right foot,
    L3030LT for the left foot)
  • CPT CODE 97762 - Check-in - Dispensing and
  • The patient's health plan benefit language and
    guidelines will determine whether these codes are
    covered (as opposed to a low-level E/M service or
    no coverage at all).
  • Obviously, if custom foot orthotics are not
    covered items under a plan, these codes are
    ineffective for evaluating those non-covered
    orthoses. Custom foot orthotics will not be
    covered by Medicare.

Custom Orthotics Billing Challenges
Drafting a 'perfect' claim - one that is
complete, accurate, and will not be rejected by
the insurance payer - necessitates a high level
of precision and precise knowledge of billing
norms and procedures. Understanding coding
caveats is the most important of these. It is
critical for practice, for example, to be able to
differentiate between CPTs and L codes, or to
understand what Insurance Company A will pay for
that Insurance Company B will not. There are also
other factors to consider. Right-foot and
left-foot orthotics must be coded and billed on
separate claim form lines with the appropriate
code and the appropriate "-RT" or "-LT"
modifiers. It's a good idea to double-check with
the provider if the codes provided aren't
adequate for accurately describing the orthotic
services done for the patient. It is risky to
assume that a catch-all or unlisted code (such as
CPT 29799unlisted casting code) can be used
discriminately, especially when a more
appropriate code exists.
Expert Assistance Is Required!
Coding errors can result in lost earnings and
revenue and if they occur too frequently, the
impact on profitability can be negative. Of
course, providers are aware of this and work hard
to outsource experienced custom orthotics billers
and coders in order to reduce such losses.
However, expertise comes at a cost, and it's
often a high one. A growing number of Orthotics
Prosthetics practices are outsourcing their
billing operations to specialized, third-party
service providers in order to reduce staff costs
while achieving the best results in billing
coding. Strategic outsourcing of key custom
orthotics billing activities to specialized,
offshore billing experts can work wonders in
drastically bringing down operational costs while
allowing providers to enjoy top quality results
minus all the usual hassles. The most significant
benefit of using a dedicated custom orthotics
billing company is that providers can instantly
access a large pool of skilled billing personnel
at a much lower cost than regular, in-house
About Us
We are a medical billing company that offers
24/7 Medical Billing Services and support
physicians, hospitals, medical institutions and
group practices with our end to end medical
billing solutions. We help you earn more revenue
with our quick and affordable services. Our
customized Revenue Cycle Management (RCM)
solutions allow physicians to attract additional
revenue and reduce administrative burden or
Contact Us
Media Contact 24/7 Medical Billing
Services Georgia 3001 Greenfield Drive, Marietta
GA Ohio 28405 Osborn Road, Cleveland, OH
4414030068 Texas 2028 E Ben White Blvd,
240-1030 Austin TX, 78741 Delaware 16192
Coastal Highway, Lewes, Delaware 19958, United
States Phone no / Fax 1 888-502-0537
Email us info_at_247medicalbillin
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