Good morning again (just posted a similar question on a different device) I was approached about an implantable device for pain control: The Morph Device (https://themorphdevice.com/) The billable codes theyre saying are 0720T and 64553. Now 64553 is payable by medicare (this device is not payable to podiatrists, but it is to NPs to which I employ). The 0720T code don't show in the Medicare fee schedule, neither code is linked to any LCD, but the rep provided EOBs showing payments. Which I know isnt guarantee of being a legitimate. I'd like to be buy the book if possible. While avoiding future clawbacks as well. 1-How does one look at the documentation or program requirements to properly document these codes? 2-Any other advice? Thank you! Luke
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As for sending a letter to the state board, I would suggest that an individual provider contact their state CAC rep and go through the channels of their state component association. The issue of obtaining coverage for a DPM for a service not previoulsy covered is usually much better handled by the state association. This issue will not just simply impact you but every other DPM in your state. If you are not a member of APMA and your state society, it should not matter as this is an issue for the greater good, than just you.
Your state association will no doubt appreciate your input and advice.
Also beware, if you do this on your own and it blows up in your face, every DPM in your state will be pointing the finger at you.
You also don't have the resources that typically the state component has to obtain an advisory decision from your state board.
Once you have a positive advisory note from the state board, you can fight with Medicare.
Having been there before, those are my suggestions.