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HCPCS Code for For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each A5513

HCPCS code A5513 for For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each as maintained by CMS falls under Diabetic Footwear .

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Official Long Descriptor

For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each

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Orthotic coding for medicare
[QUOTE="TammyHF, post: 91823, member: 2386"] HCPC L3000 through L3030 for custom orthotics which are not covered by Medicare unless it is part of a medically necessary brace. Since they are not cover ... [ Read More ]
Humana and GY modifier
We bill them out the same way you do. first they request a medical record pre-pay review. Then they deny again and when we call them, they say the review was completed with no findings so we have to w... [ Read More ]
L5000 amputation insert for diabetic shoes
I recently submitted claim to anthem medicare. I talked to someone at anthem and he just read policy from cms but did not understand why L5000 was denied for MUE. the MUE for L5000 is 0. I submitted A... [ Read More ]
L5000
[b]l5000[/b] herer is what my claim looked like and i believe we submitted correctly but they are using MUE that was triggered in suystem not to pay the claim, even though documentation shows that th... [ Read More ]
statutorily excluded services
We(podiatrists office) are receiving denials for A5513 and A5500 from MO Medicare that say statutorily excluded services. Medicare use to pay on these codes but within the last few months have stoppe... [ Read More ]
Diabetic Footwear/DME
codes A5500 through A5513 Can someone please, please enlighten me on how to get DME to pay for these? I'm having trouble with the modifiers. These claims are going electronically, until I'm sure th... [ Read More ]
Coding for O and P
A patient arrives at our practice for Diabetic medium density inserts, prescribed by his DPM. The code A5513 is assigned for the inserts. The patient needs to have a cast mold made prior to fabricat... [ Read More ]
Orthotic coding for medicare
HCPC L3000 through L3030 for custom orthotics which are not covered by Medicare unless it is part of a medically necessary brace. Since they are not cover by Medicare they would need to be submitted w... [ Read More ]
Diabetic shoes
We have been billing diabetic shoes and inserts as A5500-KX (2 units), and A5513-KX (6 units). Apparently, now DMERC wants us to add LT and RT modifiers to these. I am just curious on how everyone is ... [ Read More ]
Dmerc
[QUOTE="Kirstyn20, post: 59485, member: 21432"]I have some questions on certain LXXXX codes. We have never had an LXXXX code paid my DMERC-ever. What are the approved dx's to get these paid? I am thin... [ Read More ]
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