Wiki L4360 - widespread probe

[billybrandle1964]

Dr came back from conference and he said L4360 code was replaced by L4361. L4360 was not discontinued byt is under widespread probe. has anyone heard of L4360 replacing L4361. we are still getting paid for L4361. thanks for your help

 

[Porter_kd]

L4360 is specific for a patient by an individual with expertise. It states that it has been trimmed, bent, molded, assembled, or otherwise customized to fit the patient.

L4361 is prefabricated off-the-shelf.

Usually doctors use the L4361, unless documentation states it was customized.

 

[solocoder]

Are you located in the same facility where the boots are dispensed? You can find the correct HCPCS code somewhere on the packaging.

 

[Porter_kd]

Yes. Also the doctor is licensed to dispense DME in her office as well. I am aware there are stickers on the DME products the office orders, but unless the doctors dictates that it was customized to fit the patient, then L4361 would be their best option. In Arizona, reimbursement through Noridian DME is the same price for either L4360 or L4361.

 

[solocoder]

Some of the boots dispensed in our office have 4360 on the label and some have 4361. We use whichever code is on the boot.