The 2018 AOPA Policy Forum held March 7-8 was another success that presented realistic opportunities for O&P stakeholders to meet with Congressional representatives to improve patient care and advance other legislative objectives. With a recent legislative win under our belts, AOPA members and O&P users traveled to DC to visit lawmakers to build on this […]
News
AOPA Secures an Advocacy Victory on Reimbursement for Custom Fabricated, Direct Milled Diabetic Inserts
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 […]
So Congress (and the federal law) now says our orthotist/ prosthetist notes are officially part of the medical record for purposes of medical necessity determinations… now what?
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 […]
Opportunities for Clinical O&P Research Support from AOPA
The American Orthotic & Prosthetic Association is proud to announce 5 Requests for Proposals for separate research grants. As part of AOPA’s Orthotics 2020 initiative, we are committed to making a major leap forward in clinical research that can answer some of the most important and profound issues about Orthotics. AOPA, together with its many […]
Update: Orthotist/prosthetist notes will be considered part of the patient’s medical record by CMS!
It’s official! As a follow-up to yesterday’s announcement, with the overnight action of both Senate and House in enacting the Continuing Resolution and the spending bill, and with President Trump having signed that legislation, not only is the federal government open, but the following O&P provision is now officially signed into law: SEC. 50402. ORTHOTIST’S […]
A Legislative win for O&P
The Continuing Resolution/Spending Bill that is moving through Congress to keep the government open has provided the means to accomplish one of the key components of the O&P Medicare Improvements Act, which AOPA, its lobbyists, its members, and MANY important friends in O&P have been fighting for several years! The legislation set to be enacted […]
DME MACs Issue a Correct Coding Bulletin for Diabetic Shoe Inserts
On February 1, 2018 the four Durable Medical Equipment Medicare Administrative Contractors (DME MACs) issued a correct coding bulletin that addresses proper coding of diabetic shoe inserts described by HCPCS codes A5512, A5513, and the recently created K0903 which describes custom fabricated, total contact inserts that are manufactured through a direct milling process that utilizes […]
CMS and VA Announce Partnership to Strengthen Prevention of Waste, Fraud, and Abuse Efforts
On January 23, 2018, the Centers for Medicare and Medicaid Services (CMS) and the US Department of Veterans Affairs (VA) announced a new partnership in which they will share data, data analytics and best practices in an effort to improve both agencies efforts to combat waste, fraud, and abuse in their respective healthcare delivery systems. […]
OIG Work Plan Targets OTS Spinal and OTS Knee Orthoses
As part of its update to its 2018 work plan, the Department of Health and Human Services Office of Inspector General (OIG) announced that, based on abnormally high utilization and unusually high improper payment rates, two off the shelf (OTS) HCPCS codes that describe lumbar sacral orthoses (L0648 and L0650) and one OTS knee orthosis […]
CMS Issues Temporary “K” Code to Describe Direct Milled, Custom Fabricated Diabetic Inserts
On January 11, 2018, as part of its quarterly HCPCS update, the Centers for Medicare and Medicaid Services (CMS) issued a new HCPCS code to describe direct milled, custom fabricated diabetic inserts. The new code is effective April 1, 2018 reads as follows: K0903–For Diabetics Only, Multiple Density Insert, Made By Direct Carving With CAM […]