On November 13, 2018, the DME MACs published a revised Dear Physician letter that addresses the Medicare requirements for documentation within the referring physician’s medical records that support the medical necessity of orthotic and prosthetic services provided to Medicare beneficiaries.  This letter replaces an early Dear Physician letter, issued in August, 2011 that was retired […]

On November 1, 2018, the Centers for Medicare and Medicaid Services (CMS) announced that it is soliciting comments on its proposed inclusion of off-the-shelf spinal orthoses and off-the-shelf knee orthoses as product categories in the next round of Medicare competitive bidding.  This announcement came on the same day that the final rule on changes to […]

The Centers for Medicare and Medicaid Services (CMS) has released the new Healthcare Common Procedure Coding System (HCPCS) codes for 2019, and there were a few minor changes. Below is a complete breakdown of the code changes which will be effective for claims with a date of service on or after January 1, 2019. New […]

On November 1, 2018 the Centers for Medicare and Medicaid Services (CMS) published a final rule that addressed changes to the DMEPOS Competitive Bidding program and potential changes to the gap filling methodology that is currently used to establish Medicare fee schedules for new HCPCS codes. The final rule followed a proposed rule that was […]

On November 1, 2018, the four Durable Medical Equipment Medicare Administrative Contractors (DME MACs) released an updated Local Coverage Determination (LCD) for lower limb prostheses.  Since the changes to the LCD were minimal and do not restrict coverage, the notice and comment period required by the 21st Century Cures Act does not apply to this […]

The AOPA National Assembly Clinical Sessions Workgroup has issued a call for papers for the 102nd Annual AOPA National Assembly to be held September 25-28, 2019 in San Diego, California.  The submission deadline is March 25, 2019. Share your expertise and advance your career by being part of the country’s longest serving and largest meeting […]

On January 01, 2016, CMS launched the QIC Telephone Discussion Demonstration project to determine if engagement between suppliers and the QIC could improve the understanding of the cause of appeal denials, and lead to increased proper claim submissions. The project was originally only limited to certain DME claims, however in October 2016, the projected was expanded […]

The Centers for Medicare and Medicaid Services has announced that it will hold a special Open-Door Forum conference call to educate the public about a new initiative tasked with developing an online resource where providers and suppliers can look up the documentation requirements necessary for Medicare to cover a service or item.  While the initiative […]

The four Durable Medical Equipment Medicare Administrative Contractors (DME MACs) have recently released a revised version of the “Dear Physician” letter that addresses the need for prescribing physicians to support the medical necessity of the DMEPOS services they prescribe through proper clinical documentation in the patient’s medical record.  While the revisions to the Dear Physician […]

The American Orthotic & Prosthetic Association (AOPA) in partnership with The Journal of Neuroengineering and Rehabilitation, JNER, a BioMed Central journal partner, is pleased to announce that the supplement, “Advancements in Prosthetics and Orthotics: Selected articles from the Second World Congress hosted by the American Orthotic & Prosthetic Association (AOPA)” has been published today. The […]