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

[Guest guest]

Thank you so much for responding about this! This really helps shed some light

on the billing process.

Jake-2.5 (DOCBand Grad 9/08)

Jordan-5

>

> 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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