07/21/2022

Revised Response-When Should Insurance be Billed for Orthotics

Regarding orthotics of all insurance companies, Should billing of L 3000 code be done at time of dispensing?

Orthotics should be treated like any other DME item and billed at the time of dispensing.  It is not recommended that a provider bill for orthotics at the time a patient is casted or scanned, since the patient will need to wait for the orthotics to be ordered/made.  In addition, a patient should confirm receipt of their item.  Getting prior authorization from the patients insurance should be obtained however, that is not always a guarantee of payment. It is recommended that at time of casting a deposit is taken and at time of dispensing the balance paid.  If insurance pays you can refund the patient the money.  This of course is up to the protocols set in your office.