Direct Billing to:
| |
- Medicare Part B
- Medicaid
- Evercare (National Provider)
- Fallon
- Navicare
- Summit
- Senior Whole Health
|
- Tufts
- Blue Cross Blue Shield
- Harvard Pilgrim Health Care
- Hospice
- Worker's Compensation
- Private Pay
|
| PRODUCT |
CRITERIA |
BILLABLE CODES |
PAYORS |
| Group I |
|
|
|
| Foam Mattress (perimeter optional) |
|
E0184 |
Evercare |
| Gel Overlay |
|
E0185 |
Evercare |
| Group II |
|
|
|
| Full Mattress Replacement System |
- Multiple Stage II Decubitus Ulcers OR
- Stage III or IV Decubitus Ulcer
Must be on trunk of body |
E0277 |
Mass Medicaid
Evercare
Fallon
Summit
NaviCare
Senior Whole Health |
| Orthotic Devices |
|
|
|
- Hand Splints
- Multi-Podus
- HKO
- Knee Splints
- Elbow Splints
- LSO
- Shoulder
|
Upper and lower extremity contractures |
L3807 L0631
L4396 L3980
L1652
L1847
L1845
L1831
L3760 |
Med B/HMO
Evercare
Fallon
Summit
NaviCare
Senior Whole Health |
| Positioning |
|
|
|
| Wheelchair Cushions/Back Cushions/Gerichair Cushions |
|
E2601 E2606 K0736
E2602 E2607 K0737
E2603 E2608 E1225
E2604 E2611
E2605 E2613 |
Medicaid
Evercare
Senior Whole Health
NaviCare
Summit |
| Diabetic Footwear |
|
|
|
| Diabetic Shoes & Multi-density inserts |
Diabetes AND Secondary Dx |
A5500
A5512 |
Med B/HMO
Evercare
Fallon
Summit
NaviCare
Senior Whole Health |
|
