Re: Re: Cranial Technology should change how they do their invoices ...

[Guest guest]

Hopefully, I can shed some light on this topic since the organization I work for (Orthomerica) was responsible for the getting a billing code (S1040) for cranial remolding helmets/band that allows families to get insurance coverage for these helmets/bands.

There are multiple levels of billing codes that are used by allied health care professionals. Physicians and other select medical groups can bill under HCPCS (Health Care Common Procedure Coding System) Level I codes. These codes allow health care professionals to charge for office visits and other procedures. Cranial providers such as CTI, Hanger and orthotic companies that purchase the STARband from Orthomerica are required to use HCPCS Level II codes.

Cranial providers can not bill for office visits under HCPCS Level II codes. The product (helmet/headband) and all related services (office visits, adjustments, pictures, etc) are inclusive under S1040. As a result, cranial providers do not typically itemize their charges. If needed, these companies will typically provide you with a list of all services provided under S1040 to assist in getting reimbursement from insurance companies. It is rare for these type of providers to individually line item each charge based upon our reimbursement system.

I hope this information is helpful.

Bill Gustavson

Director of Marketing

Orthomerica Products, Inc.

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