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PMR: Training Supplies

Nicole Posted Wed 05th of September, 2018 03:15:04 AM
I have a physical medicine and rehab doctor that was interested in supplying patients with kinesiotape, therabands and ankle weights. Is this something that would be able to be billed by a physician of this specialty? If so, could you possibly advise what codes would need to be billed.
SuperCoder Answered Thu 06th of September, 2018 04:28:39 AM
Hi Nicole,
Please note that Medicare and most other insurers do not reimburse for exercise equipment used by the patient at home. The products used to deliver the service in the clinic, such as elastic bands, are considered "bundled" in the fee for service and cannot be billed separately. However, patients using these products for home exercise programs under the supervision of a healthcare professional may be billed for the cost of the items. In the unlikely event that an insurer reimburses for these products, check with the payor for specific coding requirements. Provide a full explanation of the supplies and equipment provided, being as specific as possible in regards to the patients limitations and needs. Letters of medical necessity are particularly helpful.
Hope this helps!
Nicole Posted Fri 14th of September, 2018 16:23:36 PM
I am still a little confused by the above response. The provider wants to purchase the kinesiotape, therabands and ankle weights and give them to the patients to use for 'home exercise programs' suggested by the PM&R provider. The patient will follow up with the doctor until deemed unnecessary. Per the above information, in that scenario the insurances can be billed for these items? Are there HCPC codes for these specific items or would it be an unlisted code?
SuperCoder Answered Mon 17th of September, 2018 09:31:36 AM

As specified earlier, billing codes can be used for supplies and material as well as other supplements provided during an office visit. The code you use should depend upon your goal for treatment so the best place to start is with your intention for the procedure. If it is to reduce pain or swelling, inhibit or facilitate a muscle or to provide stabilization for a functional outcome then choose your code accordingly. Please verify which codes are applicable in your region before submitting a claim. 

Good day.


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