02/28/2020

Correct Billing for A5512

I have had several nonpayments of A5512 KX RT Units = 3 and A5512 KX LT Units = 3 for 09/19/2019 and 11/22/2019 and . Both patients were billed using the Codes below. What corrections must I make to be properly reimbursed for 2019. Can you clarify the rules and billing for 2020 if I continue to use PreFab A5512 Inserts. I have read through the CMS 6 page explanation which does not state proper bill coding. Thank you.

If Medicare is paying for shoes but not the inserts, then the patient most likely received a pair within the year. A check of the same/similar should give that information or a call would have to be made. The claims are coded correctly..