AOPA Working for You
AOPA Successfully Fights for Code Exemptions from SNF PPS
AOPA
recently learned that its fight to exclude upper-limb prosthetic
replacement socket codes from the skilled nursing facility prospective
payment system (SNF PPS) was successful. Its year-long effort means
that practitioners can now deal directly with Medicare to be reimbursed
for these items, instead of having to obtain a purchase order from the
SNF.
In November 2005, the new HCPCS codes for 2006 were released and included codes L6883, L6884 and L6885, which described replacement sockets for upper-limb prosthetic devices. AOPA staff advised CMS that these codes were not yet on the list of codes excluded from SNF PPS payment rules. If codes are not on this list, providers must obtain payment directly from the SNF.
CMS’ first response was that these three codes fell outside of the range of codes exempt from the SNF payment system. After continued follow-up by AOPA staff throughout 2006, CMS officials met with AOPA in October 2006.
AOPA staff presented the case for exempting codes L6883, L6884, and L6885 from SNF PPS payment rules, and CMS officials took their arguments seriously. In January 2007, CMS released an update of the codes exempt from SNF payment system, and L6883, L6884, and L6885 were included.
AOPA will continue to work to make sure you get fair reimbursement quickly. You can stay on top of changes and successes like these by reading the members-only, bi-weekly AOPA in Advance e-mail newsletter. Sign up your entire staff today by sending the e-mail addresses you wish to receive the newsletter, along with your AOPA member ID and street address, to Corrinn Mullins at cmullins@AOPAnet.org.
If you’re not an AOPA member and want to receive the newsletter, contact Kelly O’Neill at koneill@AOPAnet.org or (571) 431-0852.
In November 2005, the new HCPCS codes for 2006 were released and included codes L6883, L6884 and L6885, which described replacement sockets for upper-limb prosthetic devices. AOPA staff advised CMS that these codes were not yet on the list of codes excluded from SNF PPS payment rules. If codes are not on this list, providers must obtain payment directly from the SNF.
CMS’ first response was that these three codes fell outside of the range of codes exempt from the SNF payment system. After continued follow-up by AOPA staff throughout 2006, CMS officials met with AOPA in October 2006.
AOPA staff presented the case for exempting codes L6883, L6884, and L6885 from SNF PPS payment rules, and CMS officials took their arguments seriously. In January 2007, CMS released an update of the codes exempt from SNF payment system, and L6883, L6884, and L6885 were included.
AOPA will continue to work to make sure you get fair reimbursement quickly. You can stay on top of changes and successes like these by reading the members-only, bi-weekly AOPA in Advance e-mail newsletter. Sign up your entire staff today by sending the e-mail addresses you wish to receive the newsletter, along with your AOPA member ID and street address, to Corrinn Mullins at cmullins@AOPAnet.org.
If you’re not an AOPA member and want to receive the newsletter, contact Kelly O’Neill at koneill@AOPAnet.org or (571) 431-0852.
