October 9, 2012 — Integrity Life Sciences, a medical device manufacturer has announced that it has received the final determination from the Pricing, Data Analysis, and Coding (PDAC) for Medicare.
The Healthcare Common Procedure Coding System (HCPCS) code determination is essential when billing for durable medical equipment (DME) products as determined by Medicare’s Administrative contractors as it relates to the Integrity Gel Support Braces.
While many suppliers elect to use other manufacturers’ determinations, this determination is specific by Medicare and is directly addressed to Integrity and related to the Integrity line of products that Integrity manufactures.
Furthermore, this determination by Medicare will facilitate and ensure accurate, reliable, and proper billing codes when submitting claims, and also speed the reimbursement process when physicians who prescribe one of Integrity’s orthotic devices for their patients seek reimbursement from Medicare.
The PDAC Contractor provides assistance to manufacturers to ensure proper coding of durable medical equipment, prosthetics, orthotics, and supplies. HCPCS was established in 1978 to provide a standardized coding system for describing the specific items and services provided in the delivery of health care.
The HCPCS codes to use when billing are:
ILS Product Number
Integrity Gel Support Brace (Small)
Integrity Gel Support Brace (Medium)
Integrity Gel Support Brace (Large)
Integrity Gel Support Brace (X-Large)
Integrity Gel Support Brace (XX-Large)
This Integrity Gel Support Brace has been approved for lumbar orthothis, sagittal control, with rigid anterior, and posterior panels, posterior extends for L-1 to Below L-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, includes fitting and adjustment.
“Orthotics and other medical supplies cannot be reimbursed through Medicare without HCPCS codes,” said Integrity’s President, James Gibson. “Additionally, most private health insurance companies follow the lead of Medicare with these types of medical products.”
Approved providers with specific questions regarding Medicare billing and coding should contact Medicare directly.
Source: Integrity Life Sciences, integritylifesciencescom