Re: Prescription format
Different people have had widely differing experiences with ACS. My
one contact with them was so frustrating that I don't intend to
contact them unless I really have to. What I was told by ACS is
that they don't have the authority to approve anything. Rather I
was informed that they administer only what has been approved by my
claims examiner. Apparently in my case, they have been told which
diagnosis (ICD-9) and procedure (CPT) codes are acceptable. If my
doctor submits something outside of the "acceptable," ACS has no
authority to do anything except to reject them. Of course, as a
claimant, the only way to find out what's acceptable is by trial and
error. No one (i.e., neither ACS nor OWCP) will provide much
information to guide you.
Some of what's acceptable doesn't even make sense. For example, in
my case, the only ICD-9 codes that ACS will accept are 493 or 493.00.
My doctor used 493.0 for years, but that will automatically reject
from ACS' system even though it's a perfectly legitimate code.
Furthermore, ACS isn't consistent. The last 6 bills that I've
submitted for reimbursement have been filled out exactly the same
way by my doctor. One was paid in full; two were not paid at all;
and three were partially paid. Go figure!
My caseworker in Congressman Bass' office won't deal with ACS
either, preferring to contact OWCP directly.
--- In firstname.lastname@example.org, FourDirect@a... wrote:
> ACS is apparently approving different coding numbers for
treatments now, too.
> The physical therapy codes that used to be covered are now
rejected and I've
> had to borrow a lot of money to continue treatment only to find
> they're all denied retroactively. Do others have this problem?
> We just keep resubmitting bills with various codes hoping that
> hit the target!!! Hard way to function.
> Kevin, have you had this problem? Others out there? I had finally
> down once London, KY took over prior to ACS and now it seems to be
> all over again... Nancy