A shift towards prevention
Remote patient monitoring CPT® codes provide a foundation for a DFU prevention program. With the Cost category accounting for 15% of your MIPS score, embracing prevention takes on added importance.
U.S. CPT® code considerations*
Remote monitoring of physiologic parameter(s) (e.g., weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on use of equipment.
Remote monitoring of physiologic parameter(s) (e.g., weight, blood pressure, pulse oximetry, respiratory flow rate), initial; device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days.
Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; first 20 minutes.
Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/ caregiver during the month; each additional 20 minutes (list separately in addition to code for primary procedure).
For diabetics only, multiple density insert, made by direct carving with CAM technology from a rectified CAD model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each.
Public System Payment
- The province of Alberta has dedicated, temporary codes and reimbursement for Orpyx SI sensory insoles
- For patients in other provinces, insoles are available as an out-of-pocket purchase
Private Insurance Supported
- Most supplemental policies pay up to C$500 per year for custom insoles with a physician’s prescription
*The reimbursement information provided is intended to provide general information concerning coding of Orpyx products only. Orpyx does not guarantee coverage or payment for any products. The ultimate responsibility for proper coding, satisfying reimbursement requirements, and obtaining reimbursement remains with the provider. Coding and coverage policies and guidelines are complex, can vary from one carrier or region to another, and are updated frequently. Providers should check with their local carriers or intermediaries often and should consult with counsel, a reimbursement specialist for coding, coverage, or billing questions. Current Procedural Terminology (CPT®) is copyright by the American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA). CPT codes and their descriptions do not reflect or guarantee coverage or payment.