Coding and Inventory of DME for Orthopedics

Event Information
Product Format
Prerecorded Event
Lynn M. Anderanin, CPC, CPMA, CPPM, CPC-I, COSC
Conference Date
Thu, Oct 26, 2017
60 minutes
Product Description

Assigning HCPCS Codes for Supplies and Braces

When a physician or therapist believes that a patient will benefit from a durable medical equipment (DME) supply or brace, it is up to the office staff to determine what healthcare common procedure coding system (HCPCS) code should be assigned for billing purposes. Unfortunately, there are many more DME supplies than codes to choose from. Join this session, where Lynn M. Anderanin, CPC, CPMA, CPC-I, CPPM, COSC, will not only guide you on the best practices in assigning HCPCS codes for supplies and braces, but will also discuss a proven way to manage inventory in the office so that reimbursement is not walking out the door of the office.

You will learn that your office does not have to lose money on DME if you are assigning the appropriate codes and managing what is going in and out of the office. The session will review how to make sure that you have a profit from DME and you aren’t losing money because of your practice pricing or what you are paying your vendor for the items. Lynn will discuss everything about DME revenue being an important part of the ancillary services of your practice.

You will be able to feel confident that you know how to choose the appropriate code for reporting of DME, which in turn will create positive reimbursements, and use your practice management system to keep inventory and know your wins and losses in DME. Insurance policies and guidelines can also help in determining when it is felt to be medically necessary for DME items, and when the patient will have to pay for these items out of pocket.

Session Highlights

  • Steps for obtaining and assigning the appropriate HCPCS code for billing
  • Using PDAC for the CMS assigned codes
  • Understand the difference between off-the-shelf, custom-fitted and custom-fabricated braces
  • Modifier requirements for clean claims
  • Using the DME fee schedule and practice costs for standardizing a fee schedule
  • Assignment of codes to use for inventory
  • Reporting from your practice management system to know what is being dispensed from your office
  • Collecting payment from patients on self-pay items not covered by insurance
  • Getting the best price from your vendors on the DME you dispense the most
  • Using ABNs for all the patients

Session Agenda

  • Overview of word search and modifier search
  • Difference between custom fabricated, prefabricated and custom fitted
  • What to do when experiencing some coding error
  • Calculating setting fees
  • Assigning appropriate codes with suffixes
  • Charges for keeping multiple items under one code
  • Overview of different modifiers
  • CMS DME fee schedule
  • Why a competitive bidding program is important
  • When ABN should or should not be used
  • What CPT code 97760 signifies
  • New CPT codes for 2018

Who Should Attend

  • Orthopedics and podiatry
  • Physicians and podiatrists
  • Coders
  • Clinical staff
  • Administrators and managers
  • Physician assistants and nurse practitioners

Ask a question at the Q&A session following the live event and get advice unique to your situation, directly from our expert speaker.

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About Our Speaker

Lynn Anderanin - Orthopedic Guidelines Expert for ICD 10

Lynn Anderanin, CPC, CPMA, CPPM, CPC-I, COSC, is the  Sr. Director of Coding Education for Healthcare Information Services, a physicians revenue cycle management company. She has over 35 years experience in all areas of the physician practice, and specializes in Orthopaedics.  Lynn is currently a  workshop and audio presenter. She is a  former member of the American Academy of Professional Coders (AAPC) National Advisory Board, and has served...   More Info
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