Custom shoes and insert on an amputee!?!

Posted By: C Jones Work on May 30, 2012


One of my prosthetic patients was steered to a national company to provide him with a custom shoe and insert. This order was from a podiatrist who I don't work with not the patient see on a regular basis.

Problem...he is a left BK and a diabetic who is on dialysis. His sound side does not present the need for a custom shoe; rather, an extra depth shoe with a wide shank would suffice.

The practitioner for this corporation provided bilateral custom shoes and 2 pair of custom inserts for both sides. Does not wear them as they aren't comfortable.

My patient is a nice guy who listened to the all-knowing prescribing doctor (pick up on the sarcasm please) and went to this corporation and the practitioner filled the prescription without questioning it's validity or appropriateness.

Yes custom shoes reimburse better than ots shoes but when it's not appropriate are we not supposed to recommend the correct device? Medicare denied and the patient had to pick up the bill!

I don't do much in the way of orthotics but am capable of recognizing what is or is not appropriate. Can my patient return the shoes and demand they do a voluntary refund? Since medicare did not pay originally, does Medicare need to be contacted on this subject so they know the shoes were returned?

Any recommendations would be good. I'm not a whistle blower but this type of stuff ticks me off. Thanks in advance

Christopher Jones, CPO

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