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| Billing Reminder - HCPCS L4210 |
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Billing Reminder: HCPCS L4210 (repair of orthotic device, repair or replace minor parts) National Government Services, the Jurisdiction B Durable Medical Equipment Medicare Administrative Contractor (DME MAC) has received several inquiries regarding the proper billing of L4210 (repair of orthotic device, repair or replace minor parts). Modifiers RT (right) and/or LT (left) should not be included on code L4210. However, the right (RT) and/or left (LT) modifiers must be used when billing specific codes for additions and replacement parts. Although an order is not necessary for the repair of an orthosis, claims for code L4210 must be accompanied by a narrative description which includes the manufacture s name, product name, and number of the part that is being billed. This information should be entered into the Note (NTE) segment of the electronic claim or Item 19 of the CMS 1500 claim form. The allowance for the labor (L4205) involved in replacing/repairing an orthotic component that is coded with the miscellaneous code L4210, is separately payable in addition to the allowance for that component. Also, L4210 must not be used for casting supplies or other materials used in the fitting or fabrication of an orthosis. If a claim is submitted that contained incomplete or invalid information and cannot be processed as submitted a CO-16 denial will be received. Suppliers should refer to the remark code (REM) on the remittance advice. The REM code advises what information is missing, invalid or incomplete on the claim. If the REM field is not complete, suppliers may contact the Provider Contact Center (866-590-6727) to request additional information regarding the CO-16 denial. Claims denied with CO-16 do not have any appeal or reopening rights. Suppliers must resubmit the claim with the missing, invalid or incomplete information in order for the claim to be processed. Remember! National Government Services' Jurisdiction B DME MAC List serv is for out going messages only. Please do not respond back to messages as your response will not be answered, as this is not an authorized mode of communication at this time, Thank You! National Government Services encourages all Web site users to provide feedback regarding ways to improve our Web site. The ForeSee Results (pop-up) survey is an easy mechanism for providers to use to let us know how we can best serve you. Your comments play a large role in the enhancements that are made to the National Government Services Web site. CONFIDENTIALITY NOTICE: This E-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply E-mail and destroy all copies of the original message. To unsubscribe/change profile: click here. Email list management powered by http://MailerMailer.com |