Re: Billing Codes for Cranial Headbands

[Guest guest]

Excellent information! We need to add this to our bookmarks

section.

Thanks

Debbie

> Hi everyone,

>

> I just received an email from a representative of Orthomerica in

> regards to recent conversations relating to billing codes. I

assume

> that the codes hold true for the DOCband as well, maybe

> could varify this for us. Anyway, here is the email I have

received:

>

>

> Niki - I have seen many questions recently regarding billing

> problems.

> If

> you feel this is appropriate, you are welcome to distribute to the

> group.

> Thanks for you all help !

>

>

>

>

> Hopefully, many of the billing problems associated with cranial

> remolding

> orthoses (headbands) will be minimized later this year.

>

> Orthomerica was successful in applying for and receiving a new

> billing

> code

> specifically for cranial remolding orthoses such as the STARband

that

> will

> be implemented effective October 1, 2002.

>

> This code can be used for any cranial remolding orthosis that meets

> the

> functional/structural requirements of the code and is intended for

> headbands

> manufactured by companies that have received 510(k) clearance from

> the

> FDA.

> While a new code does not guarantee coverage or payment, it should

> cut

> down

> on the paperwork and prior authorization problems associated with

> billing

> claims under miscellaneous codes for durable medical equipment

> (E1399)

> and

> orthotics (L1499).

>

> Good luck to all parents/caregivers in your efforts to receive

> insurance

> coverage and payment for cranial remolding orthoses. Your vigilance

> is

> one

> important reason why a new code has been created for these type of

> orthotic

> devices.

>

> If you would like more formation about this new code, please visit

> the

> press

> release section on Orthomerica's website at www.orthomerica.com.

>

> Sincerely,

>

> Bill Gustavson

> Director of Marketing

> Orthomerica Products, Inc.

[Guest guest]

Cool!! I knew they had to create a new code sooner or later. In the meantime,

a written explanation of the band and therapy will be needed.

These codes are created by HCFA (Health Care Finance Assoc I think) and can

be used by any provider that is authorized to perform the services or prescribe

the DME. From what Bill said, " the code is intended for

headbands manufactured by companies that have received 510(k) clearance from

the FDA " and since this applies to Cranial Technologies and the DOCband, I'm

sure

they will be using this code too.

Who is ? Is he a member of this board or someone at CT?

Thanks so much for the info!

ann/

NJ

DOCband 2 weeks 2 days

> Message: 14

> Date: Thu, 11 Jul 2002 17:29:08 -0000

> From: " niki_jay175 " <niki_jay175@...>

> Subject: Billing Codes for Cranial Headbands

>

> Hi everyone,

>

> I just received an email from a representative of Orthomerica in

> regards to recent conversations relating to billing codes. I assume

> that the codes hold true for the DOCband as well, maybe

> could varify this for us. Anyway, here is the email I have received:

>

> Niki - I have seen many questions recently regarding billing

> problems.

> If

> you feel this is appropriate, you are welcome to distribute to the

> group.

> Thanks for you all help !

>

> Hopefully, many of the billing problems associated with cranial

> remolding

> orthoses (headbands) will be minimized later this year.

>

> Orthomerica was successful in applying for and receiving a new

> billing

> code

> specifically for cranial remolding orthoses such as the STARband that

> will

> be implemented effective October 1, 2002.

>

> This code can be used for any cranial remolding orthosis that meets

> the

> functional/structural requirements of the code and is intended for

> headbands

> manufactured by companies that have received 510(k) clearance from

> the

> FDA.

> While a new code does not guarantee coverage or payment, it should

> cut

> down

> on the paperwork and prior authorization problems associated with

> billing

> claims under miscellaneous codes for durable medical equipment

> (E1399)

> and

> orthotics (L1499).

>

> Good luck to all parents/caregivers in your efforts to receive

> insurance

> coverage and payment for cranial remolding orthoses. Your vigilance

> is

> one

> important reason why a new code has been created for these type of

> orthotic

> devices.

>

> If you would like more formation about this new code, please visit

> the

> press

> release section on Orthomerica's website at www.orthomerica.com.

>

> Sincerely,

>

> Bill Gustavson

> Director of Marketing

> Orthomerica Products, Inc.

>

[Guest guest]

> Who is ? Is he a member of this board or someone at CT?

>

ann,

He is both! is one of our resident experts from CT who gives

tons of info regarding the DOCband.

I also assume that the DOCband will fall under this new code as well

for the reasons you have stated. I have copied and pasted a little

more info that I have received from Bill (thank you again Bill!):

National billing codes are never brand name or manufacturer

specific.

As a result, any company can bill this new code as long as they meet

the

billing requirements and have 510(k) clearance from the FDA -

including

CTI

and other manufacturers.

Over the past two years, Orthomerica has spent tens of thousands of

dollars

to get this code for our customers and parents. Hopefully, our

efforts

will

pay off for all concerned parties later this year !

[Guest guest]

Thanks for the re-intro - we have SOOOOO many new members and I forget

that they don't just jump in here knowing exactly who you are! LOL! You are

such an asset to the group - we are so thrilled that you hang with us!

Marci (Mom to )

Oklahoma

[Guest guest]

ann wrote:

>

>Who is ? Is he a member of this board or someone at CT?

>

Hello ann!

Guess it about time I re-introduce myself! But first, I want to welcome all the

new members to the Plagio group! Actually, I'm a research scientist and adjunct

associate professor at the University of Iowa. Before that I worked in clinical

research at Medical City Dallas Hospital.

I first learned about the DOC band while working in Dallas (1992??). One of the

craniofacial surgeon at Medical City asked me to study DOC banding. At first I

was skeptical BUT I was soon very impressed by how well the DOC band worked.

Over the pat 10 years I have maintained contact with the people at Cranial Tech

and occasionally serve as a consultant. In addition, I host the website at

www.plagiocephaly.org (and others see, www.Corridors.com) and provide space for

the parent support group www.plagiocephaly.org/support/.

If you're interested you can read more about me at www.kmkelly.net. Just

remember I here on the list to help and answer questions.

Regards,

<!--

M. , Ph.D.

Webworks & the University of Iowa

Learn more at http://www.KM.net.

See the sites at http://www.Webworks.com!

-->

[Guest guest]

,

Thanks for always being there for us plagio parents!

' mom