PDAC approved the Not Otherwise Classified (NOC) code L5999 for claim submissions. While O&P providers have experience billing other new innovative products using the NOC L5999 code, Ethnocare enlisted support from one of the industry’s leading reimbursement experts to help our company provide guidance to customers who are dispensing the Overlay.
Guidance for Overlay L5999 Claim Submissions:CLICK HERE
This document contains:
Details on the list price and MSRP of the Overlay
The suggested coding description to use for the Overlay
Recommendations for electronic and paper claims
Details on the reimbursement amount clinics should expect when billing the Overlay under the L5999 code
A guide on what to do if there are initial denials or medical reviews