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NCOPE Resident Business Methods March 21, 2002 Edward Barber, C.O. Methods for Teaching Business Segment of O & P • For NCOPE Residents • The Residents don’t know what they don’t know. • It’s our job to teach them or business methods so that they become valuable assets to our practices and the profession. • How do we do it? Coding Using HCPCS L-Codes • The Illustrated Guide to Orthotics and Prosthetics • Medicare coding and reimbursement guides • Medicaid coding and reimbursement guides • Understanding parent and sibling codes • Understanding exclusionary codes • Our coding “short form” CHoA O&P SHORT CODING LIST ANKLE FOOT ORTHOSIS L1945 AFO Floor Reaction L1960 AFO Posterior, Solid Ankle, Molded to Patient Model, Plastic L1970 AFO, Plastic, Molded to Patient Model with Ankle Joint L4310 Multi-Podus Splint for Lower Limb (PRAFO) ANKLE JOINTS ADDITIONS L2200 Limited Ankle Motion, Each Joint L2210 Dorsiflexion Assist, Each joint L2220 Dorsiflexion and Plantar Flexion Assist/Resist, Each Joint ADDITIONS TO LOWER EXTREMITY - MISC. L2270 Varus/Vargus Correction T Strap, Padded/Lined or Malleolus Pad L2280 Molded Inner Boot L2350 Prosthetic Type BK Socket, Molded to Patient Model (Used for "PTB AFO" Orthosis) L2375 Torsion Control, Ankle Joint & Half Solid Stirrup L2380 Torsion Control, Straight Knee Joint, Each Joint (For use when attaching Torsion Cables to AFO) L2820 Soft Interface for Molded Plastic, B K Section Medicare Billing • Patients’ portion of payment • Write-offs • Non-covered services • Waiver of liability for non-covered services • Fraud and Abuse Understanding the Paperwork • Prescriptions • Deductibles • Co-pays • Contracted prices • Signatures for receipt of services • Medicaid timeframes for submission Proprietary Information • Understanding proprietary price lists • Understanding costing of services • Recognizing the fear of your competitors getting your proprietary information Ethics •ABC Cannon of Ethics •Patient Confidentiality •Fraud and Abuse
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