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Wiki L5000 amputation insert for diabetic shoes

billybrandle1964

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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 A5500 LT and RT then a5513 for LT and L5000 RT with 1 unit. Patient has amputation. I believe it was submitted correctly. in anthems system since L5000 hits MUE their system triggers not to pay. I sent an appeal. first time it was just sitting there afterr thirty days. then they sent for reg review not through appeal process.

First can you advise if i sent correctly? any advice how to get this paid or who I could talk to. I am planning on calling them back next week.

thanks
 
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