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HCPCS CODE L4360

Shade Posted Tue 16th of December, 2014 17:48:45 PM

PLEASE HELP ME .THE INSURANCE IS DENYING HCPCS CODE L4360 WITH DX 924.20 AND 844.9. THEY ARE 2 CASES WITH DIFFERENT VISIT. A PT WAS SEEN FOR A CONTUSION AND THE OTHER PT. WAS SEEN FOR FRACTURE. BOTH CASES WERE DENIED. PLEASE EXPLAIN IN DETAIL WHAT I NEED TO DO. YOUR QUICK ANSWER WILL BE APPRECIATED. THANK YOU.

SuperCoder Answered Tue 16th of December, 2014 18:07:32 PM

Thanks for your question. Was there a specific denial reason on your explanation of benefits? See attached links for billing tips for L4360; Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise. It is possible that the diagnosis codes used with the code is the reason for the denial you are receiving.

https://www.supercoder.com/coding-newsletters/my-part-b-coding-alert/podiatry-top-tips-to-avoid-common-dme-denials-for-cam-walkers-article

https://www.supercoder.com/coding-newsletters/my-internal-medicine-coding-alert/reader-question-check-payer-guidelines-for-submitting-modifiers-133089-article

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