Great news Ron. >>> [EMAIL PROTECTED] 12/22/05 8:46 PM >>> Just a quick update.
After several denials, an appeal, and multiple e-mails to medical policy, it appears that Florida's fiscal intermediary had a 'coding error' that was preventing OT from being paid for wound care. According to my most recent e-mail from them, the error has been corrected and the claims should start paying. A small victory for OT (the Other Therapy)<smile> Ron ----- Original Message ----- From: Ron Carson <[EMAIL PROTECTED]> Sent: Tuesday, November 08, 2005 To: Charles Willmarth <OTlist@OTnow.com> Subj: [OTlist] Florida Medicare Refused to Pay for OT to do Wound Care RC> You are 100% correct. FCSO's customer service rep read the exact same RC> LCD but said they have an INTERNAL document contradicting the LCD. My RC> situation was appealed to the Operations Department who feel that the RC> internal document (which does not include OT) is correct. Apparently, RC> the INTERNAL document is based on a Medical Policy decision which RC> specifically states that OT is not reimbursable for wound care. I've RC> written Medical Policy but it can take up to 4 weeks to get a reply. RC> Chuck, do you know what CMS' policy is on OT and wound care? RC> Ron RC> ----- Original Message ----- RC> From: Charles Willmarth <[EMAIL PROTECTED]> RC> Sent: Tuesday, November 08, 2005 RC> To: OTlist@OTnow.com <OTlist@OTnow.com> RC> Subj: [OTlist] Florida Medicare Refused to Pay for OT to do Wound Care CW>> Ron, CW>> This doesn't make sense; the "FIRST COAST SERVICE OPTIONS CW>> LOCAL COVERAGE DETERMINATION CODING GUIDELINES" (revised 1/1/05) state CW>> that "Active wound care interventions as performend by physical CW>> therapists, occupational therapists, and enterostomal therapy nurses are CW>> reported by means of codes 97597 or 97598 and *97602." CW>> Chuck CW>> **************** CW>> http://www.floridamedicare.com/parta_medcov_local_Debridement%20Services-01.asp CW>> Selective debridement is reported with 97597 or 97598 and non-selective CW>> with *97602. The provider performs wound care management to promote CW>> healing using either selective or non-selective debridement techniques CW>> to remove devitalized tissue. Active wound care interventions as CW>> performend by physical therapists, occupational therapists, and CW>> enterostomal therapy nurses are reported by means of codes 97597 or CW>> 97598 and *97602. >>>>> [EMAIL PROTECTED] 11/08/05 7:28 AM >>> CW>> ============== Heads Up ================= CW>> After many long conversations with my Medicare fiscal intermediary CW>> (First Coast Service Options), they are refusing to pay for active wound CW>> care simply because the procedure was provided by an OT. According to my CW>> most recent conversations, effective January 1, 2005, wound care is only CW>> covered if done by PT, it is not covered if done by OT. I have written CW>> to Medical Policy Review but it does not look good. CW>> ===================== CW>> Ron CW>> -- CW>> Unsubscribe? CW>> [EMAIL PROTECTED] CW>> Change options? CW>> www.otnow.com/mailman/options/otlist_otnow.com CW>> Archive? CW>> www.mail-archive.com/otlist@otnow.com CW>> Help? CW>> [EMAIL PROTECTED] -- Unsubscribe? [EMAIL PROTECTED] Change options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com Help? [EMAIL PROTECTED] -- Unsubscribe? [EMAIL PROTECTED] Change options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com Help? [EMAIL PROTECTED]
