In 2016 the Center for Medicare & Medicaid Services (CMS) convened the Lower Limb Prostheses Interagency Workgroup in response to the comments received in regard to the 2015 Draft Local Coverage Determination (LCD) for Lower Limb Prostheses. The Workgroup’s purpose was to “develop a consensus statement that informs Medicare policy by reviewing the available clinical […]
AOPA and its lobbying team have been pressing CMS from all levels, most recently, including consultation with Trump Administration officials at the Office of Management and Budget, to formally implement the provisions of Section 50402 of the Bipartisan Budget Act of 2018 (Public Law 115-123) as it related to the prosthetist’s and orthotist’s clinical notes. […]
AOPA, under the auspices of its Orthotics 2020 program, circulated a request for proposals early in 2018 relating to 5 subject areas for original orthotic papers, with the original deadline for receipt of applications by April 30, 2018. Proposals have been received in all five of those categories. This notification is to announce a re-opening of […]
Recently, each of the four DME MAC contractors has published a revised version of the Dear Physician letter regarding artificial limbs. The revised version of the letter states that the Dear Physician letter is being retired due to pending guidance from the Centers for Medicare and Medicaid Services (CMS) on potential program changes that may […]
Earlier this week, AOPA provided a summary on the first report of results of Target, Probe, and Educate (TPE) audits by Noridian Healthcare Solutions, the Jurisdiction D DME MAC contractor. Since AOPA’s initial report which was limited to TPE results for “walking boot” orthoses, Noridian has published additional results for knee orthoses, spinal orthoses, and […]
Noridian Healthcare Solutions, who serves as the Jurisdiction A and Jurisdiction D Durable Medical Equipment Medicare Administrative Contractor, has released results for its initial audits under the Target, Probe, and Educate (TPE) program in Jurisdiction D. The published results are only for four HCPCS codes selected for the TPE program: L4360, L4361, L4386, and L4387, […]
In 2015 AOPA awarded a grant to Michael Dillon, PhD of La Trobe University for his project “Evaluating outcomes of dysvascular partial foot and transtibial amputation: a systematic review for the development of shared decision making resources”. The project has now been completed and the research team accomplished the following: registered the systematic review protocol […]
Recently, AOPA announced an important Advocacy victory regarding the Medicare fee schedule amount for K0903, the newly created HCPCS code used to describe direct milled, custom fabricated diabetic inserts. When K0903 was first announced, CMS indicated that the Medicare fee schedule would be approximately $5.00 less than the current fee schedule for A5513 which describes […]
AOPA is very pleased to announce an advocacy win regarding the fee structure for K0903/A5513. AOPA has confirmed with the Centers for Medicare and Medicaid Services (CMS) that the Medicare fee schedule for K0903, a temporary HCPCS code, effective April 1, 2018, that describes custom fabricated, direct milled diabetic inserts has been set at the […]
What the new law says The statute, as enacted, is comprised of one sentence which states: *SEC. 50402. ORTHOTIST’S AND PROSTHETIST’S CLINICAL NOTES AS PART OF THE PATIENT’S MEDICAL RECORD. Section 1834(h) of the Social Security Act (42 U.S.C. 1395m(h)) is amended by adding at the end the following new paragraph. ”(5) DOCUMENTATION CREATED BY […]
