05/31/2016    

SUCCESS TIPS FROM THE MASTERS

Steven Latter, DPM: When capturing casting for orthotics, should you bill a casting fee? 

 

Harry Goldsmith, DPM: If the patient’s insurance policy includes a custom foot orthotic benefit, I certainly would recommend billing for orthotic impression casting. Unlike Medicare that bundles the evaluation for AFOs, therapeutic shoes, and inserts with any casting, manufacturing, fitting, and dispensing performed by the supplier, commercial payers vary in their payment policies. While non-Medicare payers typically follow this reimbursement policy for orthotists, it is not unusual for the same commercial payers to separately pay for impression casting and the supply (custom foot orthotics) to DPMs (or MDs/DOs). 

 

In my experience as a claims reviewer, the differences between reimbursement to the orthotist and the podiatrist (for example) for the same devices is...

 

Editor's note: This extended-length response can be read here. 

 

(L-R) Dr. Robert Chelin, Jose Roofhooft, Carine Haemels, and Dr. Matt Garoufalis

 

Meet the Masters airs live every Tuesday night. This week's guests are FIP representatives Dr. Robert Chelin, Jose Roofhooft, Carine Haemels, and Dr. Matt Garoufalis. You can register for future events by clicking here.