Coding for Orthopedic Durable Medical Equipment (DME) Supplies

Event Information
Product Format
Prerecorded Event
Lynn M. Anderanin, CPC, CPMA, CPPM, CPC-I, COSC
60 minutes
Product Description

Simplifying DME Coding for Orthopedics

DME and supplies used and dispensed in the medical office and by DME supplies are direct costs to the providers that usually require payment for these items, and then reimbursement once billed to insurance carriers or paid for by patients.  It is critical that the specific insurance carrier guidelines and proper selection of the HCPCS and CPT® codes are performed to ensure the maximum allowed reimbursement for any DME or supply.

There are many tools to help with this if you are aware of where they can be found and the proper use. Understanding code descriptions can also be a vital part of reporting the right code. When dispensing these, it is important to have the correct documentation and obtain the proper paperwork when there is a question of reimbursement from the insurance carrier, and what can be done before the patient receives the supply to hold the patient accountable if it is denied. Improper coding and utilization of these codes can result in financial loses to practices.

There are rules and guidelines of when you can and cannot bill for supplies used in the office as well as braces, crutches, and other devices that maybe supplied to the patient. In this session, our expert orthopedic coding speaker Lynn M. Anderanin, CPC, CPPM, CPC-I, COSC, will focus on how to assign HCPCS codes to supplies that can be reported, and the references available to know when something cannot be reported. Current terminology for orthotics will be discussed and she will also look at what documentation you need in the patient's medical record when dispensing DME.

Coding for DME and supplies is not easy and there is specific information needed in the medical record to substantiate medical necessity. This audio conference will assist attendees in receiving the proper reimbursement, while fulfilling the requirements necessary by sharing tools for coding.

Session Highlights:

  • Review of Terminology—DME, Orthosis, Supplies and Braces, EIEIO, Prefabricated, and more!
  • Review the PDAC system for HCPCS code assignment and verification
  • Differences between Off the shelf and custom fitted orthotics
  • Proper coding for orthotic management and training
  • Insights on Modifiers
  • Drug coding
  • So many Supplies, so few codes
  • CMS DME Fee Schedules
  • Managing the office inventory for better control of profits
  • Suggestions on making sure all DME are being billed.
  • ABN: Voluntary Use of ABN
  • Understanding of general coverage guidelines for commercial insurance plans
  • Tips and tools for coding DME supplies
  • CMS documentation requirements for DME

Who should attend

Physicians in Orthopedics, Podiatrists, DME suppliers, coders, billers, Physical Therapists, Occupational Therapists

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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