Documentation and Billing Practices

by  Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
February 1st, 2016

Prescribed to:

  1. Reduce pain by restricting mobility of the trunk: OR
  2. Facilitate healing following an injury to the spine or related tissue; OR
  3. Otherwise support weak and/or deformed spinal muscles.

Documentation and billing practices be sure you are meeting all the requirements to bill a spinal orthoses.

If a spinal orthosis is delivered to a beneficiary in a hospital or SNF for use during the inpatient stay (e.g. for use after surgery and/or as part of the inpatient rehabilitation protocol), Medicare's payment to the facility covers the cost of the brace. The only exception to this rule is when the spinal orthosis is delivered to the beneficiary in the hospital within 48 hours of discharge and is intended for use at home.

References:

Documentation and Billing Practices. (2016, February 1). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/documentation-and-billing-practices-31622.html

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