Coding changes dropped, eliminated

Tuesday, January 31, 2006

Columbia, S.C. - A SADMERC work backlog has delayed new requirements for the coding of verification review for inserts and also eliminated a code for therapeutic shoes.
In December, a revision of the medical policy of therapeutic shoes for people with diabetes added the new requirements for shoes (A5500) and inserts (A5512, A5513). It was listed on Tricenturion's Web site.
The coding requirement for therapeutic shoes is being eliminated while the coding for inserts is delayed until July 1, 2006.
It's no big deal, said Dr. Paul Hughes, medical director for Region A. "They are simply not going to be able to meet the deadline to have all the codes reviewed," said Hughes. "They asked us to slim it a bit."
Manufacturers that have already submitted their products for review under current codes K0628 or K0629 will not have to resubmit.
In January 2005, Tricenturion launched a widespread service-specific prepayment probe review of diabetic shoes and inserts. The review was prompted by data analysis that indicated an increase in allowed charges for HCPCS codes A5500, A5501, K0628 and K0629 in Region A.