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Compliance and reimbursement pearls | KevinRoot Medical

Compliance and reimbursement pearls

Monthly column on billing and coding issues important to orthotic providers. These columns will provide you with a brief but thorough rationale on orthotic/prosthetic policies and billing practices.

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Surety Bond Follow up
10/8/24, 10:33 AM • Paul Kesselman 10/8/24, 10:33 AM

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Paul Kesselman
10/8/24, 10:33 AM

A recent posting outlining what happened to a pedorthic provider has some readers a bit...
Surety bond as example of what not to do
9/11/24, 10:47 AM • Paul Kesselman 9/11/24, 10:47 AM

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141
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Paul Kesselman
9/11/24, 10:47 AM

A recent encounter with a provider of DMEPOS (not a podiatrist, but a pedorthist) shoul...
L1951 3rd posting
8/21/24, 8:07 AM • Paul Kesselman 8/21/24, 8:07 AM

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303
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Paul Kesselman
8/21/24, 8:07 AM

The past two forum postings have reviewed the DMEPOS prior authorization process and the clinical...
L1951 2nd forum posting
8/7/24, 7:50 AM • Paul Kesselman 8/7/24, 7:50 AM

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321
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Paul Kesselman
8/7/24, 7:50 AM

The last forum discussed the DMEPOS prior authorization program as one way of CMS stemming the fl...
Prior Authorization Program
7/24/24, 8:07 AM • Paul Kesselman 7/24/24, 8:07 AM

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Paul Kesselman
7/24/24, 8:07 AM

Medicare, in its attempt to stem payments to providers and reduce fraud and abuse, CMS has now ex...
Proper Documentation for Custom Foot Orthotics 9
6/24/24, 5:40 PM • Paul Kesselman 6/24/24, 5:40 PM

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395
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Paul Kesselman
6/24/24, 5:40 PM

Many clients have asked beyond the HCPCS codes for custom fabricated foot orthotics and casting c...
Proper Documentation for Custom Foot Orthotics 8
6/12/24, 9:25 AM • Paul Kesselman 6/12/24, 9:25 AM

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367
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Paul Kesselman
6/12/24, 9:25 AM

Many clients have asked how to bill Medicare for custom foot orthotics when the patient’s s...
Proper Documentation for Custom Foot Orthotics 7
5/29/24, 12:04 PM • Paul Kesselman 5/29/24, 1:08 PM

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Richard Blake
5/29/24, 1:08 PM

Excellent discussion. Can not wait for the Medicare discussion next week!!! Rich Blake
Proper Documentation for Custom Foot Orthotics 6
5/14/24, 10:38 AM • Paul Kesselman 5/14/24, 10:38 AM

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Paul Kesselman
5/14/24, 10:38 AM

The last four installments in this forum dealt with the three steps of required documen...
Proper Documentation for Custom Foot Orthotics 5
4/10/24, 12:13 PM • Paul Kesselman 4/10/24, 12:13 PM

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426
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Paul Kesselman
4/10/24, 12:13 PM

The last four installments in this forum dealt with the three steps of required documentation f...
Proper Documentation for Custom Foot Orthotics 4
3/27/24, 10:54 AM • Paul Kesselman 3/27/24, 10:54 AM

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297
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Paul Kesselman
3/27/24, 10:54 AM

The last three installments in this forum dealt with the first three steps of required ...
Proper Documentation for Custom Foot Orthotics 3
2/28/24, 1:15 PM • Paul Kesselman 2/28/24, 1:15 PM

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396
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Paul Kesselman
2/28/24, 1:15 PM

The last two installments in this forum dealt with the first two steps of required documentation ...
Proper Documentation for Custom Foot Orthotics 2
2/13/24, 12:52 PM • Paul Kesselman 2/13/24, 12:52 PM

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470
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Paul Kesselman
2/13/24, 12:52 PM

Assuming all the clinical requirements for the medical necessity for custom foot orthotics have b...
Proper documentation for custom foot orthotics 1
1/31/24, 8:58 AM • Paul Kesselman 1/31/24, 8:58 AM

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623
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Paul Kesselman
1/31/24, 8:58 AM

What must I document in my patient’s chart to document medical necessity for custom foot or...
SWO Do I need one
1/17/24, 10:05 AM • Paul Kesselman 1/17/24, 10:05 AM

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112
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Paul Kesselman
1/17/24, 10:05 AM

Several colleagues have recently been hit with audit denials for an incomplete or absent Standard...
Virtual Prescribing
1/9/24, 2:10 PM • Paul Kesselman 1/9/24, 2:10 PM

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118
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Paul Kesselman
1/9/24, 2:10 PM

A great question was recently raised as to whether a physician can prescribe an AFO (or any devic...
L5000 coverage
12/13/23, 10:14 AM • Paul Kesselman 12/13/23, 10:14 AM

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501
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Paul Kesselman
12/13/23, 10:14 AM

If a patient is not a diabetic and has a partial foot amputation does Medicare cover a partial fo...
Football and DME
11/29/23, 10:36 AM • Paul Kesselman 11/29/23, 10:36 AM

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186
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Paul Kesselman
11/29/23, 10:36 AM

Often clinicians groan about third party payers and their devious schemes to deny their claims. A...
What does the KX modifier signify and when should I use it?
11/15/23, 1:44 PM • Paul Kesselman 11/15/23, 1:44 PM

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305
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Paul Kesselman
11/15/23, 1:44 PM

The KX modifier is a payment modifier used almost exclusively with HCPCS codes. It signifies to t...
PK

I am getting messages that my CEDI and Tax ID Dont Match
10/25/23, 7:54 AM • Paul Kesselman 10/25/23, 7:54 AM

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161
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PK

Paul Kesselman
10/25/23, 7:54 AM

I am new to Medicare DME and my claims are not processing as I am getting several error messages ...

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Compliance and reimbursement pearls

Surety Bond Follow up 10/8/24, 10:33 AM • Paul Kesselman 10/8/24, 10:33 AM

Surety bond as example of what not to do 9/11/24, 10:47 AM • Paul Kesselman 9/11/24, 10:47 AM

L1951 3rd posting 8/21/24, 8:07 AM • Paul Kesselman 8/21/24, 8:07 AM

L1951 2nd forum posting 8/7/24, 7:50 AM • Paul Kesselman 8/7/24, 7:50 AM

Prior Authorization Program 7/24/24, 8:07 AM • Paul Kesselman 7/24/24, 8:07 AM

Proper Documentation for Custom Foot Orthotics 9 6/24/24, 5:40 PM • Paul Kesselman 6/24/24, 5:40 PM

Proper Documentation for Custom Foot Orthotics 8 6/12/24, 9:25 AM • Paul Kesselman 6/12/24, 9:25 AM

Proper Documentation for Custom Foot Orthotics 7 5/29/24, 12:04 PM • Paul Kesselman 5/29/24, 1:08 PM

Proper Documentation for Custom Foot Orthotics 6 5/14/24, 10:38 AM • Paul Kesselman 5/14/24, 10:38 AM

Proper Documentation for Custom Foot Orthotics 5 4/10/24, 12:13 PM • Paul Kesselman 4/10/24, 12:13 PM

Proper Documentation for Custom Foot Orthotics 4 3/27/24, 10:54 AM • Paul Kesselman 3/27/24, 10:54 AM

Proper Documentation for Custom Foot Orthotics 3 2/28/24, 1:15 PM • Paul Kesselman 2/28/24, 1:15 PM

Proper Documentation for Custom Foot Orthotics 2 2/13/24, 12:52 PM • Paul Kesselman 2/13/24, 12:52 PM

Proper documentation for custom foot orthotics 1 1/31/24, 8:58 AM • Paul Kesselman 1/31/24, 8:58 AM

SWO Do I need one 1/17/24, 10:05 AM • Paul Kesselman 1/17/24, 10:05 AM

Virtual Prescribing 1/9/24, 2:10 PM • Paul Kesselman 1/9/24, 2:10 PM

L5000 coverage 12/13/23, 10:14 AM • Paul Kesselman 12/13/23, 10:14 AM

Football and DME 11/29/23, 10:36 AM • Paul Kesselman 11/29/23, 10:36 AM

What does the KX modifier signify and when should I use it? 11/15/23, 1:44 PM • Paul Kesselman 11/15/23, 1:44 PM

I am getting messages that my CEDI and Tax ID Dont Match 10/25/23, 7:54 AM • Paul Kesselman 10/25/23, 7:54 AM

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Latest topics

The Coordination of Orthoses and Symptoms Part 2

The Coordination of Orthoses and Symptoms Part 1

A Little More About Orthotics and Shoes

Latest posts

Building a Custom Foot Orthotic, Forefoot Considerations

Orthotics For the Aging Foot

Forge Your Own Path to Inspire Others

Forum statistics

Newest members

David Robinson

ktaletfbyt ktaletfbyt

GeorgefeFlene GeorgefeFlene

SandrapeBes SandrapeBes

misha shokal

Most liked authors

Richard Blake

Stefan Feldman

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Paul Kesselman

Robert Phillips

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Paul Kesselman

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Surety Bond Follow up
10/8/24, 10:33 AM • Paul Kesselman 10/8/24, 10:33 AM

Surety bond as example of what not to do
9/11/24, 10:47 AM • Paul Kesselman 9/11/24, 10:47 AM

L1951 3rd posting
8/21/24, 8:07 AM • Paul Kesselman 8/21/24, 8:07 AM

L1951 2nd forum posting
8/7/24, 7:50 AM • Paul Kesselman 8/7/24, 7:50 AM

Prior Authorization Program
7/24/24, 8:07 AM • Paul Kesselman 7/24/24, 8:07 AM

Proper Documentation for Custom Foot Orthotics 9
6/24/24, 5:40 PM • Paul Kesselman 6/24/24, 5:40 PM

Proper Documentation for Custom Foot Orthotics 8
6/12/24, 9:25 AM • Paul Kesselman 6/12/24, 9:25 AM

Proper Documentation for Custom Foot Orthotics 7
5/29/24, 12:04 PM • Paul Kesselman 5/29/24, 1:08 PM

Proper Documentation for Custom Foot Orthotics 6
5/14/24, 10:38 AM • Paul Kesselman 5/14/24, 10:38 AM

Proper Documentation for Custom Foot Orthotics 5
4/10/24, 12:13 PM • Paul Kesselman 4/10/24, 12:13 PM

Proper Documentation for Custom Foot Orthotics 4
3/27/24, 10:54 AM • Paul Kesselman 3/27/24, 10:54 AM

Proper Documentation for Custom Foot Orthotics 3
2/28/24, 1:15 PM • Paul Kesselman 2/28/24, 1:15 PM

Proper Documentation for Custom Foot Orthotics 2
2/13/24, 12:52 PM • Paul Kesselman 2/13/24, 12:52 PM

Proper documentation for custom foot orthotics 1
1/31/24, 8:58 AM • Paul Kesselman 1/31/24, 8:58 AM

SWO Do I need one
1/17/24, 10:05 AM • Paul Kesselman 1/17/24, 10:05 AM

Virtual Prescribing
1/9/24, 2:10 PM • Paul Kesselman 1/9/24, 2:10 PM

L5000 coverage
12/13/23, 10:14 AM • Paul Kesselman 12/13/23, 10:14 AM

Football and DME
11/29/23, 10:36 AM • Paul Kesselman 11/29/23, 10:36 AM

What does the KX modifier signify and when should I use it?
11/15/23, 1:44 PM • Paul Kesselman 11/15/23, 1:44 PM

I am getting messages that my CEDI and Tax ID Dont Match
10/25/23, 7:54 AM • Paul Kesselman 10/25/23, 7:54 AM