oandp.com

Can you tell me where you got the letter? I have been on the website but I have not seen anything like that, just the basic physician letter.

http://www.medicarenhic.com/dme/medical_review/mr_bulletins/mr_bulletin_current/phy_letter_artificial_limbs.pdf



Yes, definitely. I just attended the AOPA course and they said that Medicare wants the physician to assign the K level, not the prosthetist.
Yes. We have successfully gone through the RAC audits. We had to make sure the doctor's notes ( not the prosthetist's) contained a prosthetic assessment that indicated K level.

Andrea Ferraco
Human Designs Prosthetics and Orthotics
Long Beach CA

Hi Ed,

They absolutely require it.

Andrea Deshaies
Business Manager


For years we've been having physicians sign and indicate which "K" level the patient is at described in detail on the CMN. Evidently, due to several recent denials we've experienced this is "insufficient to determine medical necessity"!

There will be friends of ours losing their businesses because of this (hopefully not me) not to mention the roadblock to the rehabilitative process which limits access to care.


Edward,

The physician's documentation will require functional level in their notations or the DMERC will state that the items are not medically necessary.

Chris Haines
MaxCare Bionics


Yes. That is a major part of the physician's note.

Jim DeWees

Sent from my Verizon Wireless 4GLTE smartphone


Can you tell me where you got the letter? I have been on the website but I have not seen anything like that, just the basic physician letter.


yes it will , we have had 3 so far

Edward,
First, allow me to explain a bit more about me. I co-own Optimus Prosthetics www.optimusprosthetics.com and developed and implemented a 'best practice' to address the physicians' note requirements and, after speaking with some of my colleagues, decided to package it and offer to others. It is called 'Physician Prosthetic Assessment' (PPA) and it is the first of several products I'm offering through O&P Solutions www.OandPSolutions.net . For our industry's sake, I hope it is a short-lived product.

PPA is a stand-alone product and is separate from OPIE, Futura, Brightree, and Medflex or whatever practice management software you are using.
Attached is more info. Essentially, as Optimus' Business Director, I've done the homework for you, the busy practitioner, and am ready to debrief you (via 1-hour webinar) on what I've come up with. The PPA is ready to implement for current and future lower extremity prosthetic device deliveries as well as for past device deliveries if you are going through a post-payment audit.

There are 2 main issues that our product PPA covers: 1) the physician must be the one who assesses the patient, and, 2) the physician's narrative clinical notes must be formatted the same as the rest of his/her clinical notes in the medical record. Because the PPA covers both, Wayne van Halem, who is an audit consultant and past-Medicare Contactor, is endorsing it http://www.vanhalemgroup.com/leadership.html .

So please feel free to call myself or Beth Warren at the number below to schedule one or more webinars, free of charge.

Thank you,

-Scott

Scott Schall CP MSE BSME
CEO

O&P Solutions
8517 N Dixie Dr Ste 300
Dayton, OH 45414

937.264.9400 Office
937.264.9401 Fax
937.416.3906 Mobile




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