Reimbursement
Notice: This guide is intended for healthcare providers in the United States (No guarantee of payment)
Reimbursement Coding and Billing
This page contains information regarding the reimbursement of Neofect’s products. This information is designed for use by healthcare providers and suppliers of durable medical equipment and orthotics. For information about how patients can receive coverage for their products, please visit our For Home and Frequently Asked Questions.
Disclaimer: This website is provided for demonstrative and informational purposes only. This website is not a guarantee of coverage or payment. Consult with the appropriate healthcare insurance carrier/payer for questions about coverage of products and services. Always verify coverage, coding and payment information with the applicable health insurance carrier. For the most accurate coding information, please contact the applicable professional society or coding service provider. It is always the healthcare provider’s responsibility to determine and assign the most appropriate codes. By using this web site, you understand and agree to exclude Neofect USA Inc. from any responsibility, liability or claim. Neofect USA Inc. provides no warranty, expressed or implied as to the accuracy of this web page.
Site of Service Disclaimer: The information on this website does not provide guidance on sites of service. Healthcare providers must contact their health insurance carrier/payer for guidance and confirmation of appropriate sites of service.
CPT Codes (Procedures/Services)
HCPCS Codes (Devices, Products and Orthotics)
CPT® Codes - For Procedures and Services
Note that, each of the codes below have specific requirements that must be met in order to be eligible for assignment. These requirements may include, but are not limited to, for example, a face-to-face encounter, use of real time data platforms, limitations on frequency of billing, use of technical/professional components, and appropriate patient establishment and licensure criteria.
Therapeutic Sessions
In general, depending on which device is used, the place of service, and the clinical actions taken, the codes for physical therapy and occupational therapy may be used. Some examples of these codes are listed below.
Therapy Codes
| CPT Code | Description Example |
|---|---|
| 97110 | Therapeutic exercise procedure, on one or more areas, each lasting 15 minutes |
| 97112 | Neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture… |
| 90901 | Biofeedback therapy (1 hour) |
| 97530 | Therapeutic activities, direct (one-on-one) patient contact by the provider (use of dynamic activities) |
Always consult your health insurance carrier/payer for specific coverage and coding information for physical therapy, occupational therapy, and other services.
Reviewing Data From a Neofect Device
Depending on the device and amount of data available, it may be possible to assign codes related to the review of data. This includes data that is either collected from the patient’s home-use device, or from a clinic. Since Neofect devices provide data used in clinical evaluations, as well as physiologic data, the codes for data monitoring could potentially be assigned.
Data Interpretation Codes
| Code | Description |
|---|---|
| 99091 | Collection and interpretation of health data that is generated by a patient remotely, digitally stored and transmitted to the provider, at a minimum of 30 minutes of time |
| 99453 | 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 Patient Care, Telehealth and Monitoring
If a healthcare provider and patient qualify for services to be covered on a remote basis, there are several codes that could be applicable. Each scenario for remote patient care should be confirmed directly by contacting the healthcare insurance carrier/payer prior to billing.
Remote Service Codes
| Code | Description |
|---|---|
| 99421 | Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5–10 minutes |
| 99422 | Online digital evaluation and management service, for an established patient, for up to 7 days cumulative time during the 7 days; 11– 20 minutes |
| G2061 | Qualified non-physician healthcare professional online assessment and management, for an established patient, for up to seven days, cumulative time during the 7 days; 5–10 minutes |
| G2062 | Qualified non-physician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 11–20 minutes |
| G2063 | Qualified non-physician qualified healthcare professional assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 21 or more minutes |
| G2012 | Brief communication technology-based service when the patient checks in with the practitioner via telephone or other telecommunications device to decide whether an office visit or other service is needed |
| G2010 | Remote evaluation of recorded video and/or images submitted by an established patient |
| 99457 | Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; first 20 minutes 99458: each additional 20 minutes |
HCPCS II Codes - For Devices, Products, and Orthotics
Note: these codes are examples for informational purposes only, and are not presented as a guarantee of coverage, coding, or payment. It is the healthcare provider’s responsibility to contact the healthcare insurance carrier/payer to confirm the most specific codes and the resulting coverage and payment for their specific circumstances.
Healthcare Common Procedure Coding System (HCPCS) Level 2 codes generally represent physical products for reimbursement. These codes are commonly used by suppliers and distributors of medical equipment and orthotics to describe products on a health insurance claim form.
Neofect manufactures several medical device products that are registered with the US Food and Drug Administration (FDA). The HCPCS codes for these regulated medical device products are listed below.
Medical Device HCPCS Codes
| Item | HCPCS Code | HCPCS Description |
|---|---|---|
| Neofect Smart Glove Kit* - FDA Class II | A9300 | Exercise equipment |
| Neofect Smart Board - FDA Class II | E1399 | Misc. DME |
*Note: For bilateral applications of the Neofect Smart Glove, it may be required to use modifier -LT to designate the Left hand device and modifier -RT for the right hand device.
Neofect has also created devices and software that are not regulated by the FDA. Their information is listed below.
Orthotics HCPCS Codes
Neofect is the manufacturer of orthosis for different applications, including braces, slings, and grasping aids. Examples of HCPCS codes for these products are shown below.
| Item | HCPCS Code | HCPCS Description |
|---|---|---|
| Neofect Extender Basic | L3912 | Hand finger orthosis (HFO), flexion glove with elastic finger control, prefabricated, off-the-shelf |
| Neofect Extender Plus | L3931 | Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment |
| Neofect Drop Foot Brace | L4398 | Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf |
| Neofect Foot Up Brace | L2999 | Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf |
| Neofect Positioning Pillow | E0190 | Positioning cushion/pillow/wedge, any shape or size, includes all components and accessories |
| Neofect Shoulder Brace | L3670 | Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf |
| Neofect Neomano | E1399 | Durable medical equipment, miscellaneous |
Non-Medical Device and Software HCPCS Codes
| Item | HCPCS Code | HCPCS Description |
|---|---|---|
| Neofect Smart Pegboard | E1399 | Misc. DME |
| Neofect Cognition Kit & Software | E1399 | Misc. DME |
Resources for Healthcare Providers regarding Reimbursement:
For general questions about specific codes submit a question to the AHA Coding Clinic.
Additional Resources:
American Physical Therapy Association (APTA) Coding and Billing
American Occupational Therapy Association (AOTA) Coding and Billing