DC’s billing for Foot Levelers to DMERC

I just got off the phone with a chiropractor who said that Medicare (DMERC) requested back all of the monies that he and others had been paid for claims that they had submitted for foot levelers using HCPCS code L3020. Foot Levelers are custom-made inserts that are placed in your shoe to help improve your body’s balance, posture, and alignment. Many chiropractors offer them to patients and do the scans right in their office. They send the images out to Foot Levelers (the company) and the inserts are sent back to the chiropractor. They then provide the inserts to the patient. If the patient has medical insurance it can be billed. Medicare has been reimbursing for the services.

Now they are stating that the code, L3020 is not appropriate for what the patient is being supplied with (the inserts) and that a chiropractor cannot prescribe them. They state that they must be prescribed by an MD or DO.

So far we’ve only heard this from one dr, but he states that he’s aware of others that have also received similar requests. He is planning on fighting the decision and is currently researching it.

Anyone else come across this issue yet?

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4 Responses to “DC’s billing for Foot Levelers to DMERC”

  1. Matthew Christopher Says:

    Unfortunately, he is probably correct that chiropractors can’t bill for DME without an MD or DO order for the supplies, even if we are DME suppliers. I had a friend suggest that we become DME suppliers, but we opted not to because once we dug into the Medicare regulations it was pretty clear that we can supply the DME to patients but we can’t write the order. I regret that I can’t remember where in the regulations we read that, but I do know that chiropractors can only bill CMT codes and cannot write orders for anything else, including DME. I wish him luck with his appeal, but it probably will not be a good outcome.

  2. Claudia Says:

    I was surprised to hear the chiropractor was reimbursed at all. As Matthew stated, the only thing Medicare pays for as far as DCs goes, is the CMT. I billed for a big chiro office for over 10 years and we had many Medicare patients. It’s great to have them because they are good at telling others how good their chiropractor is, thereby referring a lot of people to the office, but the reimbursement from Medicare is dismal.

  3. DW DC, CPED Says:

    Medicare does not reimburse for L code foot orthotics, there is more to this story trust me. They do allow diabetic beneficiaries who meet specific criteria and are documented and referred by an MD/DO to be provided approved shoes and orthotics but DC’s are not approved suppliers to provide these services. They will reimburse the trained professions (DPM, CO, CPed) for diabetic shoes and insoles.

    There is a growing trend among group health insurers who offer benefits for L code foot orthotics to deny payment to DC’s as many use Foot Levelers an they are considered “investigational”.

    You are correct that DC’s cannot order or refer in Medicare so as Claudia commented I am also surprised to hear that Medicare approved or reimbursed for them at all. If Medicare makes such an error at some point their Recovery Audit Contractors (RAC’s) will eventually recoup the inappropriate payment.

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