All You Want to Know About Custom Orthotics Billing
                     All You Want to Know About Custom 
Orthotics Billing
Most providers involved in the field of orthotics and prosthetics are 
concerned about billing for orthoses. This is especially true for O&P 
providers because the burden of getting paid for services rendered 
frequently falls squarely on their shoulders. Such concerns would not 
have existed in a cash-only practice. But that is not the case. A modern 
practice must recoup costs from the patient's insurance provider. This 
includes preparing and submitting a formal claim for reimbursement. 
That’s why it is crucial to know everything about custom orthotics billing. 
Here is a glimpse of the orthotics and prosthetics providers: 
Read more…
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All You Want to Know About Custom 
Orthotics Billing
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Custom Foot Orthotics Insurance 
Coverage:
• CPT CODE #97760 - Examination, Designing, Casting, and 
Education
• HCPCS CODE L3000 - Foot, removable insert, molded to patient 
model, 'UCB' type.
• HCPCS CODE L3030 - Foot, removable insert, formed to patient foot, 
each 
• (MODIFIER – Left and Right Foot will be billed separately i.e., 
L3030RT for the right foot, L3030LT for the left foot)
• CPT CODE #97762 - Check-in - Dispensing and Fitting
• The patient's health plan benefit language and guidelines will 
determine whether these codes are covered (as opposed to a low-
level E/M service or no coverage at all).
• Obviously, if custom foot orthotics are not covered items under a plan, 
these codes are ineffective for evaluating those non-covered 
orthoses. Custom foot orthotics will not be covered by Medicare.
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       Custom Orthotics Billing Challenges: 
Drafting a 'perfect' claim - one that is complete, accurate, and will not be 
rejected by the insurance payer - necessitates a high level of precision 
and precise knowledge of billing norms and procedures. Understanding 
coding caveats is the most important of these. It is critical for practice, for 
example, to be able to differentiate between CPTs and L codes, or to 
understand what Insurance Company A will pay for that Insurance 
Company B will not.
There are also other factors to consider. Right-foot and left-foot orthotics 
must be coded and billed on separate claim form lines with the 
appropriate code and the appropriate "-RT" or "-LT" modifiers. It's a good 
idea to double-check with the provider if the codes provided aren't 
adequate for accurately describing the orthotic services done for the 
patient. It is risky to assume that a catch-all or unlisted code (such as 
CPT 29799—unlisted casting code) can be used discriminately, 
especially when a more appropriate code exists.
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 Expert Assistance Is Required!
Coding errors can result in lost earnings and revenue and if they occur 
too frequently, the impact on profitability can be negative. Of course, 
providers are aware of this and work hard to outsource experienced 
custom orthotics billers and coders in order to reduce such losses. 
However, expertise comes at a cost, and it's often a high one. A growing 
number of Orthotics & Prosthetics practices are outsourcing their billing 
operations to specialized, third-party service providers in order to reduce 
staff costs while achieving the best results in billing & coding. 
Strategic outsourcing of key custom orthotics billing activities to 
specialized, offshore billing experts can work wonders in drastically 
bringing down operational costs while allowing providers to enjoy top 
quality results minus all the usual hassles. The most significant benefit of 
using a dedicated custom orthotics billing company is that providers can 
instantly access a large pool of skilled billing personnel at a much lower 
cost than regular, in-house staff. 
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About Us
We are a medical billing company that offers ‘
24/7 Medical Billing Services’ and support physicians, hospitals, 
medical institutions and group practices with our end to end medical 
billing solutions. We help you earn more revenue with our quick and 
affordable services. Our customized Revenue Cycle Management 
(RCM) solutions allow physicians to attract additional revenue and 
reduce administrative burden or losses.
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Contact Us
Media Contact:
24/7 Medical Billing Services
Georgia
3001 Greenfield Drive, Marietta GA
 
Ohio
28405 Osborn Road, Cleveland, OH 4414030068
Texas
2028 E Ben White Blvd, #240-1030 Austin TX, 78741
Delaware
16192 Coastal Highway, Lewes, Delaware 19958, United States
Phone no / Fax :  +1 888-502-0537
                          Email us: [email protected]
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