June 2011 O&P Almanac

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The American Orthotic & Prosthetic Association

JUNE 2011

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WWW.AOPANET.ORG

THE MAGAZINE FOR THE ORTHOTICS & PROSTHETICS INDUSTRY

GETTING PAST

THE PAIN

An understanding of the whole patient promotes comprehensive treatment options

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O&P Almanac JUNE 2011, VOLUME 60, NO. 6

COVER STORY

20 Getting Past the Pain

By Deborah Conn Chronic pain among amputees is nearly universal, but finding the best treatment among the myriad options requires a lot of trial and error. From electrodes to mirror therapy, learn some of the various pain management methods available to find the best treatment options for your patients—not just their pain.

COLUMNS

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Reimbursement Page Simplifying VA contract negotiations

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Ask the Expert An in-depth overview of the PECOS enrollment system

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Facility Spotlight Amputee Prosthetic Clinic

DEPARTMENTS

FEATURE

28 Advancements in Caring for Pelvic-Level Amputations

By Jill Culora Hip disarticulation and hemipelvectomy (HDHP) patients are a small, but growing, segment of the O&P community—and that increase has spurred numerous technological advances in the past three years. Experienced practitioners discuss the latest products and best practices for restoring mobility to HDHP patients.

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AOPA Contact Page How to reach staff

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At a Glance Statistics and O&P data

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In the News Research, updates, and company announcements

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SPECIAL FEATURE

48 O&P Buyers’ Guide 2011

The 2011 Buyers’ Guide is an invaluable directory filled with in-depth information about products and services for the entire O&P industry. This handy resource also features a comprehensive index of advertisers and AOPA member suppliers for easy reference.

CONTENTS

AOPA Headlines News about AOPA initiatives, meetings, member benefits, and more

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AOPA Membership Applications

70 Jobs

Opportunities for O&P professionals

76 Calendar 79

Ad Index

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AOPA Answers

Expert answers to your FAQs

O&P Almanac (ISSN: 1061-4621) is published monthly by the American Orthotic & Prosthetic Association, 330 John Carlyle St., Ste. 200, Alexandria, VA 22314; 571/431-0876; fax 571/4310899; email: almanac@AOPAnet.org. Yearly subscription rates: $59 domestic; $99 foreign. All foreign subscriptions must be prepaid in U.S. currency, and payment should come from a U.S. affiliate bank. A $35 processing fee must be added for non-affiliate bank checks. O&P Almanac does not issue refunds. Periodical postage paid at Alexandria, VA, and additional mailing offices. Postmaster: Send address changes to: O&P Almanac, 330 John Carlyle St., Ste. 200, Alexandria, VA 22314. For advertising information, contact Dean Mather, M.J. Mrvica Associates Inc. at 856/768-9360, email: dmather@mrvica.com.

JUNE 2011 O&P ALMANAC

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OP Almanac

AOPA CONTACT INFORMATION

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AMERICAN ORTHOTIC & PROSTHETIC ASSOCIATION (AOPA) 330 John Carlyle St., Ste. 200, Alexandria, VA 22314 AOPA Main Number: 571/431-0876 AOPA Fax: 571/431-0899 www.AOPAnet.org

EXECUTIVE OFFICES

MEMBERSHIP AND MEETINGS

Thomas F. Fise, JD, executive director, 571/431-0802, tfise@AOPAnet.org

Tina Moran, CMP, senior director of membership operations and meetings, 571/431-0808, tmoran@AOPAnet.org

Don DeBolt, chief operating officer, 571/431-0814, ddebolt@AOPAnet.org O&P ALMANAC Thomas F. Fise, JD, publisher, 571/431-0802, tfise@AOPAnet.org Josephine Rossi, editor, 703/914-9200 ext. 26, jrossi@strattonpublishing.com

Tom Wessel, director of business development, 651/724-8753, twessel@AOPAnet.org Kelly O’Neill, manager of membership and meetings, 571/431-0852, koneill@AOPAnet.org Steven Rybicki, communications manager, 571/431-0835, srybicki@AOPAnet.org

PUBLISHER Thomas F. Fise, JD EDITORIAL MANAGEMENT Stratton Publishing & Marketing Inc. ADVERTISING SALES M.J. Mrvica Associates Inc. DESIGN & PRODUCTION Marinoff Design LLC PRINTING United Litho Inc.

BOARD OF DIRECTORS OFFICERS President Thomas V. DiBello, CO, FAAOP, Dynamic O&P, a subsidiary of Hanger Orthotic and Prosthetics Inc., LLC, Houston, TX

Michael Chapman, coordinator, membership operations and meetings, 571/431-0843, mchapman@AOPAnet.org

President-Elect Bert Harman, Otto Bock Health Care, Minneapolis, MN

Dean Mather, advertising sales representative, 856/768-9360, dmather@mrvica.com

Ann Davis, office, meetings administrator, and associate editor, AOPA in Advance, 571/431-0876, adavis@AOPAnet.org

Treasurer James Weber, MBA, Prosthetic & Orthotic Care, Inc., St. Louis, MO

Steven Rybicki, production manager, 571/431-0835, srybicki@AOPAnet.org

AOPA Bookstore: 571/431-0865

Catherine Marinoff, art director, 786/293-1577, catherine@marinoffdesign.com

Ann Davis, staff writer, 571/431-0876, adavis@AOPAnet.org Teresa Tobat, editorial/production assistant, 703/914-9200 ext. 33, ttobat@strattonpublishing.com

GOVERNMENT AFFAIRS Kathy Dodson, senior director of government affairs, 571/431-0810, kdodson@AOPAnet.org Devon Bernard, manager of reimbursement services, 571/431-0854, dbernard@AOPAnet.org Joe McTernan, director of coding & reimbursement services, education & programming, 571/431-0811, jmcternan@AOPAnet.org Reimbursement/Coding: 571/431-0833, www.LCodeSearch.com a

AMERICAN ORTHOTIC & PROSTHETIC ASSOCIATION SERVING THE O&P FIELD FOR OVER 90 YEARS

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O&P ALMANAC JUNE 2011

Vice President Tom Kirk, PhD, Hanger Orthopedic Group, Austin, TX

Immediate Past President James A. Kaiser, CP, Scheck & Siress, Chicago, IL Executive Director/Secretary Thomas F. Fise, JD, AOPA, Alexandria, VA

DIRECTORS Kel M. Bergmann, CPO, SCOPe Orthotics and Prosthetics Inc., San Diego, CA Rick Fleetwood, MPA, Snell Prosthetic & Orthotic Laboratory, Little Rock, AR Michael Hamontree, OrPro Inc, Irvine, CA Russell J. Hornfisher, Becker Orthopedic Appliance Co., Troy, MI Alfred E. Kritter, Jr., CPO, FAAOP, Hanger Prosthetics & Orthotics Inc., Savannah, GA Eileen Levis, Orthologix, LLC, Philadelphia, PA Anita Liberman-Lampear, MA, University of Michigan Orthotics and Prosthetics Center, Ann Arbor, MI

NEW! UPDATE MEMBERSHIP DIRECTORY INFORMATION ONLINE

Mahesh Mansukhani, MBA Ossur Americas, Aliso Viejo, CA Frank Vero, CPO, Mid-Florida Prosthetics & Orthotics, Ocala, FL Copyright 2011 American Orthotic and Prosthetic Association. All rights reserved. This publication may not be copied in part or in whole without written permission from the publisher. The opinions expressed by authors do not necessarily reflect the official views of AOPA, nor does the association necessarily endorse products shown in the Almanac. The Almanac is not responsible for returning any unsolicited materials. All letters, press releases, announcements, and articles submitted to the Almanac may be edited for space and content. The magazine is meant to provide accurate, authoritative information about the subject matter covered. It is provided and disseminated with the understanding that the publisher is not engaged in rendering legal or other professional services. If legal advice and/or expert assistance is required, a competent professional should be consulted.

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At a Glance

Pain Management Facts and Figures Amputees Experience Phantom Pain Most Often…

Phantom Pain Most Bothersome to Amputees…

Frequency of Amputation-Related Pain Never

Sometimes

Perception of Amputation-Related Pain Severity

Always

Not bothered

Somewhat bothered

Extremely bothered

70% 59% 45%

21%

70%

45% 38%

32% 20%

60% 60%

54% 54%

27%

22%

18%

19%

27%

24%

14% 7%

PHANTOM LIMB PAIN

RESIDUAL LIMB PAIN*

BACK PAIN*

PHANTOM LIMB PAIN

RESIDUAL LIMB PAIN*

BACK PAIN*

Source: “Phantom Pain, Residual Limb Pain, and Back Pain in Amputees: Results of a National Survey 2005,” Archives of Physical Medicine and Rehabilitation *Numbers have been rounded and may not total to 100 in some instances.

2.2 times

The prevalence of self-reported back pain among amputees compared with estimates for the general U.S. population.

85%

Percentage of all amputees who experience phantom pain.

27 million Estimated number of adults who had osteoarthritis in 2005.

80%

Percentage of patients who experience residual pain at some point following a major extremity amputation.

1:2

Ratio of people who will develop

symptomatic knee osteoarthritis.

8 to 10 times The greater chance women have for developing Morton’s neuroma than men.

Sources: Neurology at the Uniformed Services University of the Health Sciences 2007, 2010; American Academy of Orthopaedic Surgeons 2001; Atlas of Limb Prosthetics: Surgical, Prosthetic, and Rehabilitation Principles; “Phantom Pain and Phantom Sensations in Upper Limb Amputees: An Epidemiologic Study,” Pain 2000; “Phantom Pain, Residual Limb Pain, and Back Pain in Amputees: Results of a National Survey 2005,” Archives of Physical Medicine and Rehabilitation 6

O&P ALMANAC JUNE 2011

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In the News

Computer Model Shows Role of Feet, Toes in Balance Building a better prosthesis may become possible, thanks to computer modeling. Ohio State University researchers say the results from a computational model of how foot and toe strength influence balance may help in designing a prosthetic that can better imitate natural movement. The study’s findings were published in the Journal of Biomechanics.

The researchers designed a computational model in which four different sections represented different parts of the foot, and one represented the body. This allowed researchers to focus primarily on measuring the pressure of the feet and toes.

The study involved simulations of static balance—that is, standing straight or at a certain angle and remaining stable in that position

with the entire bottom of the foot on the ground—as well as leaning forward. Researchers performed three tests for multiple situations: static balance in healthy subjects, static balance with decreased toe strength, and forward leaning in healthy subjects.

Results showed that in a healthy person, the toes become increasingly important as the person leans forward. As the computer model leaned forward, the pressure underneath the toes increased and the pressure

underneath the heel decreased.

The lead researcher of the study, Hooshang Hemami, noted that the data from the computational model matched data from similar studies of human subjects and should provide a more realistic model for studying balance.

“Now that we have a reasonable computer model, we hope to explore, in the future, the sensory apparatus and other functions of the toes in diverse human activities,” Hemami says. “We try to model what muscles do, which may help to develop more advanced prosthetics, so we have something better to offer people who need them.”

VA Gives Aid to Paralympic Veterans

Photo: Jeff Huehn

Kortney Clemons, U.S. Army - 2012 U.S. Paralympic Team hopeful (track & field)

Some veterans participating in the Paralympics may qualify for a monthly subsistence allowance from the U.S. Department of Veterans Affairs. This new program is designed to encourage physically challenged veterans to participate in competitive sports.

The allowance will be administered by the U.S. Paralympics.

Qualifying veterans must meet the following requirements: have a disability, receive an invitation from the organization to compete for a position on the U.S. Paralympic team, or reside at a U.S. Paralympic training center.

Applications for the allowance must be submitted through the U.S. Paralympics website, http://usparalympics.org.

Steve Bosson, U.S. Army - 2012 U.S. Paralympic Team hopeful (archery)

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O&P ALMANAC JUNE 2011

In the News Photos: Thomas Webster Nanomedicine Lab/Brown University

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Brown University researchers have created nanoscale surfaces, seen above, that act as natural seals and may prevent infections at the prosthetic device implantation sites.

New Skin Surfaces Prevent Infection Researchers have created nanoscale surfaces that build natural seals and prevent infections. These surfaces potentially could help stop infections at sites where prosthetic devices are implanted.

Brown University researchers designed the nanoscale surfaces to act as skin cell magnets that, over time, build natural seals, according to findings published in the Journal of Biomedical Materials Research. They modified the surfaces of titanium leg implants to promote skin cell growth and also created a molecular chain to sprinkle skin-growing proteins on the implant to hasten skin growth.

Researchers took two approaches to create the natural seals. In the first method, they fired an electron beam of titanium coating at the piece of the implant that is inserted into the bone, creating a landscape of 20-nanometer mounds. The mounds imitate the contours of natural skin and encourage skin cells to colonize the surface and reproduce.

The second approach, called anodization, involved dipping the abutment into hydrofluoric acid and giving it a jolt of electric current. The titanium atoms on the abutment’s surface shuffle and regather as hollow, tubular structures rising

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O&P ALMANAC JUNE 2011

perpendicularly from the abutment’s surface. Skin cells then quickly colonize the nanotubular surface.

In laboratory tests, the researchers reported that skin cells on the surface of the implant almost doubled in density.

Within five days, an impermeable skin layer had been created, bridging the abutment and the body.

To further promote the growth of skin cells around the implant, researchers created a synthetic

TRANSITIONS

molecular chain to bind the protein FGF-2 to the titanium leg while maintaining the protein’s ability to help other skin cells grow. Tests showed the greatest density of skin cells on abutment surfaces on the nanomodified surfaces that were laced with FGF-2.

The next step would be performing in-vivo experiments, and eventually human trials, although researchers say that could take years.

PEOPLE IN THE NEWS

Hanger Orthopedic Group and its nonprofit organization, the Hanger Ivan R. Sabel Foundation, recognized prosthetists Anna Avakian, CPO, Vern Hostetler, CPO, and Jay Tew, CP, for their work in restoring mobility and independence to Haitian amputees at the Hanger Clinic in Deschapelles, Haiti.

Hanger also promoted Thomas Bourgeois and Amy Schaumburg to regional sales manager positions. Schaumburg will cover Missouri, Wisconsin, and Illinois, and Bourgeois will cover Texas, Oklahoma, and Colorado.

Steven Hoover, CP, LP, COA, has joined College Park Industries as Technical Service Manager. Hoover will provide clinical support to customers and instruct College Park’s clinical application workshops.

Bianca Kajlich, star of the show “Rules of Engagement,” held a Twitter campaign to raise funds for the Amputee Coalition’s Paddy Rossbach Youth Camp. In honor of her birthday on March 26, Kajlich asked her followers to make contributions to send 100 children with limb loss to summer camp.

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In the News Potential Treatment Discovered for Heterotopic Ossification

New research reveals a promising treatment for heterotopic ossification (HO), an often-debilitating abnormal buildup of bone tissue. By using agents derived from vitamin A, scientists at the Children’s Hospital of Philadelphia prevented HO in

TRANSITIONS

The Amputee Coalition announced that Hanger Orthopedic Group has pledged $45,000 to the Amputee Coalition’s Bridge to Ability Fund over the next three years. This fund will support scholarships to new amputees to attend the Amputee Coalition’s 2011 National Conference,

O&P ALMANAC JUNE 2011

stimulates the growth of skeletal cells.

These cells develop into cartilage cells, which are then replaced by intrusive bone. HO is not fatal, but bone-growths may press against nerves and blood vessels, resulting in pain, limited motion, and problems fitting prosthetic devices.

Researchers used nuclear retinoid agents, a class of agents related to vitamin A that targets a regulatory pathway during cartilage formation—a major step in the HO development process. The agents prevented HO from occurring in mice that had been genetically engineered to model the condition.

The protective measure also appeared to be permanent, preventing HO even after treatment had ended.

Authors of the study cautioned that more preclinical trials are necessary before retinoid agents are tested in humans. The U.S. Department of Army and National Institutes of Health sponsored the study. a

BUSINESSES IN THE NEWS

The Alabama Commission on Higher Education recently granted Alabama State University’s College of Health Sciences permission to offer a master’s of science in prosthetics and orthotics program—the only program in the state. ASU is the only historically black university that offers such a degree.

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mice and are hopeful this treatment could work for humans, according to a study published in the research journal Nature Medicine.

The cause of HO is not fully understood, but trauma, surgery, and deep burns cause local inflammation, which

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The Amputee Coalition’s Limb Loss Task Force released a white paper, “Roadmap for Limb Loss Prevention and Amputee Care Improvement.” The inaugural Limb Loss Task Force met in Washington, D.C., on April 16-18, 2010, to develop a Four Point Action Plan that is outlined in the recently released white paper. View the document on www. amputee-coalition.org.

The Challenged Athletes Foundation hosted its annual Heroes, Hearts and Hope gala on June 8 in

New York City. Proceeds from the gala will raise awareness of physically challenged athletes.

Essentially Women hosted its 11th annual conference and trade show, Focus on the Future, in Glendale, Arizona, April 4-6.

The London Organising Committee of the Olympic Games and Paralympic Games will host International Paralympic Day on Sept.

8, 2011, in London’s Trafalgar Square.

Ticket applications for the London 2012 Paralympic Games open the following day.

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Reimbursement Page

By Joseph McTernan, AOPA government affairs department

Taking the Mystery Out of VA Contracting Navigate the complex process with this step-by-step guide

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egotiating a contract with an insurance company can be stressful to say the least.

When the negotiations are with a federal payer like the U.S. Department of Veterans Affairs (VA), the additional red tape and bureaucracy can make the experience almost painful.

This month’s Reimbursement Page focuses on ways to make the VA contracting experience less stressful. As with most things, the key to success is a solid understanding of how the process works.

Preparing to Contract If you want to serve as a vendor to the federal government, including the VA health-care system, you must first take a few steps to qualify as a federal contractor.

Start by applying for a Data Universal Numbering System (DUNS) number. A DUNS number is a unique, nine-digit number that verifies the existence of your company on a global basis. The federal government uses a company called Dun & Bradstreet to issue and maintain DUNS numbers, and there is no charge to obtain one.

Apply online at http://fedgov.dnb.com/

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O&P ALMANAC JUNE 2011

webform/pages/CCRSearch.jsp or by calling 866/705-5711.

DUNS numbers are usually issued within one or two business days if you apply using the web-based form, and a little longer if you apply by telephone.

Either way, registration will only take 10 to 15 minutes of your time, but it is a crucial step in becoming eligible to do business with the federal government.

With your DUNS number in hand, you must now register with Central Contractor Registration (CCR). Registration in CCR became mandatory as of Oct. 1, 2003, for any business competing for contracts covered by Federal Acquisition Regulations (FAR).

Registration is done completely online and may be accessed at www.bpn. gov/ccr/default.aspx. Once on the site, click on the “Start new registration” button. If you are new to the CCR registration process, a User’s Guide is available for download in PDF or Microsoft Word format at www.bpn. gov/ccr/handbook.aspx.

CCR registration is free but will take longer than applying for a DUNS number. It should not take more than an hour to complete the CCR registration process, however. While several companies may offer to help

you “find” government contracting opportunities for a fee, they are usually simply registering you in CCR, which you can do yourself for no cost.

Finding Contracting Opportunities Now that your company is officially registered as a government contractor, the next step is to make sure you’re aware of current or upcoming contracting opportunities.

One of the best ways to do this is by visiting the Federal Business Opportunities (FedBizOpps) website at www.fbo.gov. You are not required to register, but doing so will make navigating the site easier. To register, locate the box that says “Vendors/ Citizens” and click on the “Register Now” link. This will open a new window where you can enter your DUNS number. Click on “Proceed,” and the information on file for your DUNS number should automatically transfer into the FedBizOpps system.

During the registration process, you will create a username and password to use when logging in during future visits. Once you are logged into the site, you can search for contracting opportunities with the

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Reimbursement Page

federal government. An important fact to remember is that the FedBizOpps site contains information on all federal contracting opportunities.

The key to an effective search is narrowing your search criteria enough that you are only searching for information regarding artificial limbs and braces, but not so much that you might miss an opportunity.

This is where the search field under the “Opportunities” tab comes into play. When you click on this tab, a new window opens where you may enter search criteria. In the box labeled “Keyword Search,” enter basic terms, such as “artificial limb,” “prosthetics,” or “orthotics.” Searching for each of these terms should turn up any contracting opportunities that you may be interested in.

Another way to ensure you don’t miss contracting opportunities is to contact the Veteran’s Integrated Service Network (VISN) and speak directly to the contracting officer(s).

Contracting with the VA is handled at the VISN level.

There are currently 23 VISNs throughout the United States. Each has a dedicated website with contact information for its headquarters and the VA medical centers in its jurisdiction. A detailed map of the 23 VISNs with links to each of them may be found at www2.va.gov/directory/ guide/division_flsh.asp?dnum=1. Actual requests for proposals (RFPs) are released by the contracting officer at the local VISN. When you speak to the officer, explain who you are, what you provide, and that you would like to be placed on a potential vendor list for orthotic and prosthetic services.

VISN contracting officers are not required to maintain vendor lists, but they usually do to make sure that contracting opportunities are widely publicized. Contacting the local officer directly also develops a professional relationship that may prove valuable throughout the contracting process and the administration of the contract once it has been awarded.

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O&P ALMANAC JUNE 2011

Figuring Out the VA Contract Process Contracting with the VA is a complex process—after all, the party on the other side of the table is the federal government. The VA contracting process is regulated through FAR and must follow a very specific process.

While the full details of the contracting process cannot be explained in a single article, here are some of the more important factors: • Length of contract. The majority of VA contracts are awarded for a period of three to five years, usually with one or more “base” years and several “option” years. During the base term of the contract, usually one to three years, both parties are bound to the terms of the contract.

During the option years, either the VA or the O&P facility may choose to renew or terminate the existing contract without penalty. Once an option year is renewed, the terms of the existing contract remain in effect until the next option year, at which time the contract can again be terminated by either party.

• Set-asides. Under FAR regulations, contracting officers must

ensure that the interests of small businesses are considered when contracts are awarded. Depending on the ability of these businesses to provide adequate levels of service in the area where the proposed contract will operate, the contracting officer may issue the RFP with either a full set-aside or a partial set-aside. If 100 percent of a contract is set aside for small businesses, then only those companies that qualify as small businesses may submit a proposal. In areas where the need cannot be met by small businesses, the contracting officer may issue the RFP with a partial set-aside, usually a percentage of the overall contracts that will to be awarded.

• Discount. Because contracting with the VA is a competitive process, most RFPs will contain a section for indicating the discount you are willing to provide as a percentage off the Medicare fee schedule.

What discount you offer, if any, is a business decision that should be based on your understanding of the competition as well as what your business can afford.

• Number of contract awards.

The RFP will usually provide an estimate of the number of contracts that will be awarded. While the final number of contract awards may be more or less than the estimate, it may prove helpful in determining the level of discount that you may be willing to offer.

• Proposal due date. This is a very important part of the contracting process, as the contracting officer may not be permitted to accept proposals that are returned after the due date. Whenever you receive an RFP, you should note its due date and make sure not to miss the deadline.

• Contract administration. Following the RFP process, the contracting officer will review the submitted bids, ensure that any set-aside requirements have been met, evaluate the bids, and then issue

Whenever you receive a request for proposal, you should note its due date and make sure not to miss the deadline. contract awards to the selected bidders. The companies that have been awarded contracts will be notified and sent a final copy of the contract for required signatures.

If you are awarded a contract, it is important to keep an executed copy of it in case there are any questions during the base and exercised option years. By signing the contract, you agree to be bound by its terms for the full base period.

Once the base period expires, you may elect to renew any option years

on an annual basis.

Note that if you are not awarded a contract, you may continue to serve veterans with whom you have an existing clinical relationship. To continue providing services in this scenario, however, you must be willing to accept the payment terms of the VA, sometimes at the lowest negotiated rate of the existing contract awards.

Although contracting with the VA can often be frustrating and complex, it also may represent a crucial segment of your O&P business.

Proper preparation and negotiation are valuable tools in ensuring continued access to this important line of business. a Joe McTernan is AOPA’s director of coding and reimbursement services.

Reach him at jmcternan@ AOPAnet.org.

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Led by Joe McTernan, AOPA Medicare expert; Brian L. Gustin, CP; and Jonathan M. Naft, CPO, this seminar gives you the tips and hands-on experience you need to get paid for all of your O&P services.

For more information and register online at www.AOPAnet.org

Dycor’s new Heavy Duty FDS energy‐returning prosthetic foot (HD‐FDS, L5981) is designed specifically for unassisted ADL (K3).

Keel deflection specifications are determined by computing Body Mass Index (BMI). Multiply the weight of your client in pounds by the foot size in centimeters. The HD‐FDS foot is recommended when the resulting value is between 7,500 and 10,000. Complete weight (including EVA foot shell and titanium pyramid) is between 6‐16 ozs., depending on weight and foot size.

The FDS foot is a non‐ stocked, customized product. Please allow 3 working days for processing. For additional information, contact Dycor’s technical service department.

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Getting Past

the Pain BY

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O&P ALMANAC JUNE 2011

DEBORAH CONN

COVER STORY

Understanding the complex causes of amputees’ pain is the first step in finding comprehensive, whole-patient treatments

N

o one—especially not anyone who has lost a limb—will be surprised to learn that chronic or recurring pain among amputees is nearly universal. Unfortunately, a common remedy for that pain isn’t.

Treatment is complicated because the causes vary, and each type of pain calls for a different approach.

In most situations, prosthetists find that while every approach may work with at least one amputee, no treatment succeeds with everyone.

As a result, their work frequently involves a trial-and-error process that may combine a number of therapeutic modalities. However, one consensus exists among practitioners: The bestfitting, most functional prosthesis is essential to successful treatment.

Residual Limb Pain A common source of pain in the residual limb is an ill-fitting socket.

After an amputation, it typically takes about a year for the residual limb to settle in size, according to Danica Nordstrom, CO, a neuro rehabilitation specialist at Chicago-based Scheck & Siress. Even then, the limb’s volume varies throughout the day, making it difficult to achieve a consistent fit; and scar tissue may be sensitive, particularly early on. Managing that type of pain calls first for making socket modifications as often as necessary and experimenting with a variety of socket and liner materials.

Neuromas present a more complex pain issue. “Whenever a nerve is cut, the end of the nerve heals itself by forming a small bulb, called a neuroma,” explains Christina Skoski, MD, who spent 30 years as a clinical anesthesiologist and is herself a hemipelvectomy amputee. “If you’re lucky, the neuroma is small and hidden deep in the tissue, and it won’t bother you. But if the neuroma is larger and close to the skin, it can be extremely painful.”

JUNE 2011 O&P ALMANAC

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COVER STORY

Ridding the Ghost Sheck & Siress, an O&P facility based in Chicago, lists these recommendations that may help patients cope with phantom limb pain: •

Wrap the limb in a warm, soft fabric, such as a towel. The warmth will sometimes increase circulation. Poor circulation is thought to be one causes of phantom pain.

•

Mentally exercise the limb that is not there in the area that is painful.

• Mentally relax the missing limb.

• Do some mild overall exercise to increase circulation.

• Physically exercise the limb.

• Tighten the muscles in the limb and then release them slowly.

• Put an ace wrap or shrinker sock on the residual limb. If you have your prosthesis, put your prosthesis on and take a short walk.

• If you have pain with the prosthesis on, take it and the prosthetic sock off and put it back on after a few minutes. Sometimes the limb is being pinched, and changing the way the device is on will relieve the pressure on that nerve.

• Change positions. If you are sitting, move around in your chair or stand up to let the blood get down into your stump.

• Soak in a warm bath or use a shower massage. Sitting in a whirlpool or hot tub also can be helpful.

• Massage your limb with your hands or, better yet, have someone else massage it while you try to relax your entire body.

• Keep a diary of when pain is most severe. This can help you and your doctor identify causes for reoccurring phantom pain.

• Acupuncture and biofeedback also are techniques that have been used successfully with some people.

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O&P ALMANAC JUNE 2011

Managing neuromas is complex.

One approach is to cut back the nerves and try to hide the ends deep in tissue. But surgical removal can be problematic because the cut nerves will only form new neuromas. Other treatments include such physical approaches as the application of heat or cold, exercise, massage, or tightly wrapping the residual limb.

Pharmacological interventions are occasionally successful, but often come with unwanted side effects and complications. Physicians may try nerve blocks or injecting medications to deaden the neuroma. In every case, a well-fitting prosthesis is essential.

Another approach attempts to block pain signals from reaching the brain. Transcutaneous electrical stimulation (TENS) involves placing electrodes on the painful area and sending low-voltage electrical current through the underlying muscles as it travels from one electrode to the other.

This triggers a reflex in the spinal cord that interferes with its ability to send pain signals to the brain.

Neuromuscular electrical stimulation (NMES) is a similar technology that creates contractions in the muscles and improves blood flow as well as scrambling pain signals.

NMES also can be useful with residual limb pain caused by muscle atrophy, says Philip Muccio, CPO, president and CEO of Axiobionics LLC, in Ann Arbor, Michigan. “When muscles atrophy from disuse, the socket places more pressure on the bone. This can be greatly improved by stimulating the muscles and causing them to grow,” he explains. “When they are denser, they can take more of the load and improve distribution of pressure inside the socket.”

In addition, limited blood flow can trigger pain attacks. Both TENS and NMES increase circulation, bringing more blood to the affected area.

Axiobionics makes stimulators that patients can wear inside the socket or use when they are not wearing their prosthesis. The company is in the process of developing a socket with built-in electrodes.

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Muccio cites a patient who tried to function for five years with a reconstructed leg. His pain was so relentless that he elected to have the leg amputated below the knee. He spent another five years in severe pain, says Muccio, but after 30 days of NMES therapy was completely free of pain.

With more muscle mass and density, he was able to increase his activity level and today considers himself to have no disability at all—despite his prosthesis.

Unfortunately, not every amputee will experience the same results. “When I see patients, we do up to a two-week evaluation to see if they respond to TENS or NMES,” says Nordstrom. “I don’t know why it works so well for some patients and not for others.”

Phantom Pain Phantom pain, or pain that feels as though it originates in a limb that no longer exists, is extremely common among amputees, particularly in the first year or so after amputation. This pain is in no way imaginary: Research has identified physical activity in the brain that registers as pain. One may lose a foot, for example, but the nerves that controlled sensation in the foot still exist in the parts of the body that remain. The brain doesn’t recognize that the distal portion of the nerves has been removed and interprets signals from the remaining nerves as originating in the foot.

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O&P ALMANAC JUNE 2011

Skoski makes a distinction between phantom sensation and phantom pain.

“Many people have the sensation that the limb is still there. It may tingle or itch or burn, feel hot or cold, or it may seem to be in an unnatural position,” she says. Phantom sensation can be bothersome, or it can fade into the background. Skoski likens her phantom sensation to radio static: “I have it all the time, but I don’t think about it.”

By contrast, phantom pain occurs in bursts, and it can be excruciating. The frequency and duration of phantom pain episodes vary widely, and treatment often aims to reduce the number of episodes and the intensity of the pain, rather than attempting to eliminate it entirely.

Determining what triggers an episode of phantom pain can be helpful. “I have about three episodes a year,” says Skoski, “and they are usually related to changes in the weather and barometric pressure.”

Other common triggers include anything that causes swelling and edema, changes in diet, sensitivities to food preservatives, and mental or physical stress.

“Just coming down with a cold or the flu can manifest as phantom pain,” she says. “An episode can also signal more serious medical problems.”

Treatments for phantom pain, like other kinds of pain, run the gamut

from physical and medical interventions to psychological and alternative approaches. For most patients, using more than one method is likely to be the best strategy.

Physicians may prescribe medication for phantom pain, including narcotics, anti-inflammatories, antidepressants, muscle relaxants, and anti-seizure drugs, or combinations of these medications.

But, they rarely solve the problem on their own.

“We as a nation are looking for pharmacological salvation,” says Skoski. “We want an easy answer. But with something as complicated as phantom pain, nine times out of 10, medicine is only part of the solution.”

TENS and NMES often are used for phantom pain, with electrodes placed on the residual limb in proximity to the nerve that once served the severed appendage. The trick is to stop the nerves from firing, says Muccio. “It’s like rebooting your nervous system.”

Another useful technology can be biofeedback, which uses electrodes to monitor muscle tension and other autonomic body functions such as heart rate and brain activity. By watching these activities on a computer monitor, patients learn to release tension in their bodies and control the pain response.

Carolyn Burns, PT, who practices at Northwest Hospital Center in Baltimore, has used desensitization on the residual limb to treat both local and phantom pain. The treatment begins by stroking the limb with an extremely soft material, such as silk or cotton balls. The therapist gradually escalates into more noxious stimuli—moving, for example, from textured corduroy to a stiff washcloth to a bristle brush—as the patient’s tolerance increases.

“The idea is to stimulate overactive nerves to get them to calm down,” says Burns. General massage can be helpful as well by relaxing muscles, increasing blood flow, and contributing to an overall sense of well-being.

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COVER STORY

Amputee Roberta Cone, PsyD, participates in multiple-mirror therapy—a treatment for phantom limb pain in which mirrors are used to trick the brain into seeing two working limbs. Cone lost her arm in an automobile accident almost 10 years ago, and has used multiple-mirror therapy to treat her phantom limb pain.

Photos: David H. Peterzell, PhD

Mirror Therapy In the late 1990s, V.S. Ramachandran, MD, a neuroscientist at the University of California in San Diego, described the use of a mirror box to help amputees who suffered from phantom limb pain. Patients used a mirror to reflect the intact limb, tricking the brain into seeing two working limbs. When they flexed and stretched the existing limb, the patients felt movement in the missing limb and were able to release the feeling that their phantom limb was stuck in a frozen, uncomfortable position. In studies, the majority of patients who used the mirror box for 15 minutes a day, five days a week, not only reported less pain, but many experienced the perception that the phantom limb itself was shrinking in size.

In a variation on Ramachandran’s work, Roberta Cone, PsyD, is conducting clinical trials on the use of triple mirrors. Cone, who lost her arm in an automobile accident nearly a decade ago, had tried single-mirror therapy with no success. Desperate, and in severe phantom limb pain one evening, she walked into her bathroom and started experimenting with different angles on the threesection medicine cabinet mirror.

“I put my limb behind the mirror and as I looked at it, my pain vanished instantaneously,” she recounts. Free from phantom pain ever since, Cone

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O&P ALMANAC JUNE 2011

began a relationship with the Veterans Administration in San Diego and is studying both single and triple mirror therapy with veterans and civilians.

She expects to publish the results in September 2012.

Mirrors also can be combined with therapeutic massage to create the sensation that the therapist is massaging and relaxing the muscles of the missing limb.

Other alternative therapies include magnets, energy work such as acupressure and acupuncture, and nutritional supplements. No hard data exist as to the efficacy of these methods, but some amputees have found them useful. Even a placebo effect is useful if it reduces pain.

Treating the Whole Person Chronic or severe pain affects every aspect of an amputee’s life, which is why it is so important to treat the whole person, not simply the pain. “For people in chronic pain, so much has to do with their attitude and what else is going on in their lives,” says Skoski.

A member of the Medical Advisory Committee of the Amputee Coalition, she is a strong proponent of amputee support groups. “Being able to talk about your pain to people with similar concerns can be enormously helpful,” she says. The Coalition offers peer support and resources for counseling and education. Cognitive and

behavioral therapy can keep amputees from spiraling into depression or despair, and experts agree that a positive attitude and high level of activity can do much to lessen the perception of pain.

“The bottom line in treating amputee pain is that you can’t just take one approach,” says Skoski.

“You can’t just take a pill and have it go away. You need to find a comprehensive pain management program that will offer any and all of the treatments.” Pain management has become a big business, she notes, but most facilities focus on back or neck pain, so it’s important for amputees to find a program that understands their needs, particularly when it comes to phantom pain.

Skoski urges amputees to take advantage of information about pain provided on the Amputee Coalition’s website. “You can look up every article that has been written about pain, and you can access them all online,” she says. “This can be very helpful, because every amputee thinks he is the only one.

“Try to understand what your triggers are, and look for treatments that may work for you,” she advises amputees. “Everyone will find their own way.” a Deborah Conn is a contributing writer to O&P Almanac. Reach her at debconn@ cox.net.

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BY

JILL CULORA

Technological innovations facilitate better outcomes for this small but growing group of patients

T

reating hip disarticulation and transpelvic patients can be an intriguing departure from the routine. But the challenges associated with this amputee population might be daunting to those who aren’t fully up-to-date with the latest knowledge and technology.

In the past, hip disarticulation and hemipelvectomy (HDHP) patients represented only 0.5 percent of all lower limb amputations. These days, however, 2.2 percent of all limb amputations among injured soldiers returning from Iraq and Afghanistan are HDHP procedures. And advances in surgical techniques mean pelvic-level amputations are saving the lives of more trauma patients. The recent growth in this small population coincides with some exciting technological advances, especially in the past three years.

HDHP patients face greater challenges

than other lower limb amputees for a variety of reasons, many associated with the fact that three weight-bearing joints are lost: the hip, the knee, and the ankle.

An amputation at the hip—either as disarticulation, meaning removal of the lower limb at the hip level, or transpelvic, meaning removal of the lower limb plus a portion of the pelvic bone—is more complicated than amputation at the knee or ankle joints because it affects sitting, has a greater impact on balance and weight distribution, and can affect bowel, bladder, and sexual functions.

In addition, controlling a hip disarticulation prosthesis is extremely challenging, as a lower-torso “swing through” motion is physically demanding and takes a lot of practice. Patient discomfort on the load-bearing prosthesis is another serious concern, and it often leads to rejection of the device.

JUNE 2011 O&P ALMANAC

29

Newer and Better Scott Sabolich, CP, LP

New developments in materials and components are helping address some of these issues. Among the latest offerings are softer plastics, gel liners that aid in suspension, better hip joints, and smarter and better knees.

“With newer products and newer components, like the new hip joints that are out, we can actually conceive that a hip disarticulation patient can walk downstairs—they can ambulate.

It’s because of proper fitting techniques mixed with the technology coming out,” says Scott Sabolich, CP, LP, owner of Scott Sabolich Prosthetics & Research in Oklahoma City.

The new hip Sabolich is referring to is a Helix3D hip joint system by Otto Bock. It is a polycentric, hydraulically controlled hip joint that provides motion on both the sagittal and transverse planes, allowing it to mimic a normal hip more closely than earlier devices.

“In the old days, hip joint devices only moved in one plane—like a door hinge,” he adds. “They were very fragile—they broke, and they were a pain. Even with a C-leg or other computerized knee with it, it still was a very antiquated, hard to walk with prosthesis. Hips don’t move on one plane like a door hinge. They move on all planes—like a ball and socket. Even when a person walks, their legs don’t go straight forward and straight back, they go in a circumferential, circumductive gait.”

The Right Approach

Helix3D - Systematic Fitting

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O&P ALMANAC JUNE 2011

David Rotter, CPO, clinical director of prosthetics for Scheck and Siress, who is based at the University of Illinois, recommends taking different approaches with HDHP patients depending on whether they are new prosthesis users, previous or long-term users, or previous users who have rejected the device in the past but are considering giving it another try.

New users might be at an advantage over previous users, says Rotter. If their insurance will cover the latest technology, they can learn to use the device without having

been accustomed to previous components that work differently. The new technology feels very different from traditional hip devices, and, for the highly motivated, it provides the best opportunity to ambulate.

Updating devices for patients who currently wear older, more traditional devices requires a “slow weaning off” process. “If they are a prosthetic wearer, then whatever system they have is what they know, and it’s almost like the body and brain are hardwired to make the mechanism work,” says Rotter. “So you might want to change one variable at a time—for example, a new socket, then a new hip joint, and knee joint, so that the person can feel the difference and slowly acclimate themselves without being overwhelmed with the different feelings.”

With each component change, Rotter starts the patient on the parallel bars and then using a cane so the patient can work out how the mechanism operates before ambulating on their own. “A standard 7E7 hip joint, which is basically just a single hinge, then going to the Helix, which is a polycentric mechanism with a hydraulic, is a very different feeling,” Rotter says. “It can be both exciting and disconcerting for the person who is used to a certain type of feeling for the leg underneath them.”

Patients who have previously rejected a device might be using crutches or a wheelchair for mobility, allowing them to get around more quickly than they will at first with the new prosthesis. Since they’ve already experienced disappointment and rejected a device, setting realistic goals is crucial so patients don’t have the same experience all over again.

“It’s important not to promise someone the moon, even though you have these new and exciting offerings,” says Rotter. “I ask them what their goals are to get a sense of their expectations. It might be to go shopping, to stand with peers at social functions— those are all very realistic goals. I use establishing realistic goals as a starting point. If the patient finds he wants to

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David Rotter, CPO

use the prosthesis more extensively as he gets more experience, that’s great. If not, then there isn’t that same feeling of disappointment.”

Rotter further recommends establishing realistic goals with any patient.

“It’s important to preach realism, not just to say that the latest and greatest is going to do all the work,” he says.

“There is work involved, and for someone who uses a prosthesis at this level of amputation, it is a commitment to do the work.”

The Right Fit Because discomfort on the loadbearing prosthesis is a common reason patients reject devices, obtaining an optimum socket fit is essential, says Mark Edwards, MHPE, CP, director of professional and clinical services at Otto Bock HealthCare in Minneapolis.

“The socket fit has to be intimate in the anterior and posterior dimension so that patients have good control when they do use their pelvis to make the prosthesis move,” he says. “There must be no lost motion when they want to make the prosthesis function.”

The next issue is the suspension. “If there’s no lost motion up and down, then patients will have an easier time

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O&P ALMANAC JUNE 2011

clearing the floor in swing phase, so it makes it more efficient to walk, because they do less gait deviations in order to compensate for a prosthesis that’s not holding on so well,” says Edwards. This is achieved by taking an accurate impression, modifying the cast correctly, and making sure the check socket has been fabricated and assessed properly.

The alignment of the prosthesis is critical because the patient has no control over the prosthesis in stance phase, says Edwards. “There’s no lever arm for them to control the prosthesis, so the prosthetist has to align it in such a way that it is stable for walking, but not so stable that it becomes inefficient,” he adds.

“It is complicated because you are balancing three joints and everything is a closed kinetic chain, so everything affects everything,” says Rotter. “The hip placement affects the knee, the knee affects the foot, and they all affect each other, so it’s important that all the phases are working together and efficiently and they are complementary of one another.”

Gait Training Typically, gait training falls under the care of a physical therapist, but as Rotter points out, there are so few HDHP patients that it’s unrealistic to expect a physical therapist to know exactly how to gait-train this type of patient. He suggests giving patients strong basic criteria on how to ambulate with the device.

“It’s important to know when to cue a person to stand with their shoulders erect, to stand with good posture, and then to initiate the movement to their hip,” he says. “I spend a lot of time in the gait-training process with my patients teaching them how to utilize technology—for example, how to best take advantage of all the components that are underneath them. It isn’t just automatic. You can’t expect someone to intuitively understand—you have to work with the person to give them that very solid foundation on how to optimally activate the prosthesis.”

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Design is the difference

The newest components will provide the best opportunities to ambulate, but this doesn’t necessarily mean a patient will be successful because the energy and motivation required often exceeds a person’s strength or will. It is estimated that a hip disarticulation amputee needs to use 200 percent more energy to ambulate than an able-bodied person.

“It’s untenable to use 200 percent more energy with each step, and, in reality, they don’t use that,” Rotter says.

“What they do is auto-regulate the energy they are expending by slowing their speed down. So someone with a hip disarticulation prosthesis will tend to walk a little slower so that they are not expending that level of energy.

There’s also technique: Someone who has been using the device for a long time knows how to use it in the most efficient way that they can. As they go through their gait cycle, they know exactly when to move their pelvis with the least amount of effort.”

For some, the effort is not worth the reward, Rotter says. “There are people who just say, ‘I’m not going to bother with this, it’s easier to use crutches or a chair.’ And then there are people who have the motivation and say, ‘This is important to me, and I’m going to do this.’ More than anything else, it is the motivated person that stands the best chance of success.”

Physical Conditioning HDHP patients considering a prosthesis or those who have a newly acquired one need to work on their physical conditioning, especially their core strength—stomach and back muscles—and their posture.

“It’s the muscles that aren’t normally used in walking. They need to focus in on those core muscles to provide them with the strength in order to function with the prosthesis correctly,” says Edwards. “They need to be able to stand up nice and tall in

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O&P ALMANAC JUNE 2011

the prosthesis and use their stomach muscles to propel that prosthesis forward, and that is an aspect that a lot of individuals never master very well because they either don’t get enough physical therapy or training, or they just don’t spend the time to focus on those muscles to get them good at doing the things they need to do to ambulate correctly.”

Assistive devices such as crutches or canes are often used to help with balance either as a temporary or a permanent measure. “The better balance the patient has, the less reliance they will need on assistive devices,” Edwards says. “Any time you can take something out of a person’s hand and keep their hands free for walking and doing other things, then you’ve freed them up to walk better, have more confidence, more balance, and they can do activities in daily living better.”

Some patients do need that help, however. “Some people just don’t have the balance because of other medical complications, or they just aren’t trained enough to get their balance because they never shift their weight onto the prosthesis enough,” Edwards says. And, he adds, others simply feel more stable using crutches or a cane.

The HDHP population is a small one, and it could be the case that a practitioner goes a few years between seeing such patients. Many advances could have been made in the intervening years, so to get the best patient outcome, practitioners should brush up on the basic principles, review fitting procedures, and contact manufacturers and fabrication services to seek the most up-to-date product and component options.

“If this is your first patient and you know someone you can get advice from, then do so—there’s no shame in that,” says Rotter. “Everyone is going to benefit—most importantly of all, the patient.” a Jill Culora is a contributing writer to O&P Almanac. Reach her at jillculora@ gmail.com.

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Ask the Expert

By Joseph McTernan, AOPA government affairs department

PECOS and O&P Learn the relationship between this enrollment system and your business

A: There was a time when the word PECOS conjured up images of old west towns and gunslingers named Bill. In today’s Medicare world, PECOS has an entirely different meaning. This month’s Ask The Expert column will provide an overview of the PECOS system and explain the potential impact it may have on your O&P business.

Q: A:

What exactly is PECOS?

PECOS is an acronym that stands for Provider Enrollment Chain and Ownership System. What we will discuss in this article specifically is Internet-based PECOS, which is the preferred method of Medicare enrollment for providers and suppliers.

Q:

Is PECOS available for my O&P company to use instead of the paper 855S enrollment form?

A:

Yes. Effective October 4, 2010, DMEPOS suppliers, including O&P suppliers, became eligible to use the PECOS system for the purposes of enrolling or re-enrolling in the Medicare program.

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O&P ALMANAC JUNE 2011

Q:

Is it mandatory for DMEPOS suppliers to use PECOS to enroll/re-enroll as a Medicare provider?

A:

No. The National Supplier Clearinghouse (NSC) will continue to accept the paper 855S supplier enrollment form for the foreseeable future. While the use of PECOS will most likely become the only enrollment/re-enrollment method available to providers at some point in the future, it is currently only one option for providers.

Q:

Can I register as a supplier in the PECOS system without actively enrolling or re-enrolling?

Yes. Registering for access to the PECOS system is an independent process and not actually part of the enrollment/re-enrollment cycle. Because the process can be complex, you may want to register your organization on the PECOS system before it is time to enroll or re-enroll your organization as a Medicare provider.

Q: A:

How do I register my organization in PECOS?

There is an excellent online resource available at www. cms.gov/MLNProducts/downloads/ MedEnroll_PECOS_DMEPOS_ FactSheet_ICN904283.pdf. This document, published by the Centers for Medicare and Medicaid Service (CMS), provides a general overview of how the PECOS system works and how DMEPOS suppliers can register for and subsequently use the PECOS system.

Q:

What are some advantages of using PECOS to enroll/ re-enroll as a Medicare DMEPOS supplier?

A:

Some of the advantages of using PECOS are reduced processing times (average of 45 days as opposed to 60 days for paper enrollment), the ability to review the

information in your provider file and quickly correct any errors, and a reduction in the overall administrative burden of completing the paper version of the 855S.

Q:

What are some of the disadvantages of using the PECOS system?

A:

The biggest disadvantage is that PECOS does not allow you to submit all of the information required to enroll or re-enroll as a Medicare DMEPOS supplier. While the application process itself occurs online, you will still be required to submit hard copy documentation to support your application. Anything that is typically required as an attachment to the paper 855S form will still need to be sent to the NSC. Examples of these required items include a full copy of your liability insurance policy, any required surety bond information,

and copies of any required state and local licenses that are required for your business to operate.

Q:

If I have previously enrolled as a Medicare provider by completing the paper 855S form, will my organizations information be automatically added to the PECOS system?

A:

According to CMS, the enrollment records of all DMEPOS suppliers will eventually be added into the PECOS system regardless of whether a DMEPOS supplier is registered to use the PECOS system. The transfer of information in your supplier file to the PECOS system does not eliminate the need for you to register as a PECOS user in order to review or update your information, nor does it eliminate the need for you to register to enroll or re-enroll using the PECOS system.

What is the status of the requirement that referring physicians must be enrolled through PECOS in order for DMEPOS suppliers to accept referrals from them?

A:

CMS has suspended the implementation of this requirement until further notice. Eventually suppliers will only accept referrals from physicians who have current enrollment files in the PECOS system. CMS has acknowledged that implementation of this requirement currently represents a potential undue burden to the supplier community and therefore has delayed it until a future date. CMS has assured the supplier community that it will provide sufficient notice prior to the implantation of this requirement. a Joe McTernan is AOPA’s director of coding and reimbursement services. Reach him at jmcternan@AOPAnet.org.

TM

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JUNE 2011 O&P ALMANAC

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Facility Spotlight

By Deborah Conn

Building on a Dream Quick turnaround, personal care, and a homey atmosphere distinguish Amputee Prosthetic Clinic

Jim Young, CP, FAAOP

FACILITY:

Amputee Prosthetic Clinic

LOCATION:

Macon, Tifton, and Albany, Georgia

OWNER:

Jim Young, CP, FAAOP

HISTORY:

6 years in business

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O&P ALMANAC JUNE 2011

F

or years, Jim Young’s, CP, FAAOP, dream was to open his own prosthetic facility, and in 2005 he did exactly that. After leaving a successful prosthetic career in Macon, Georgia, Young set out to find a town outside the 50-mile radius mandated in his non-compete agreement. He settled on Tifton, Georgia, a place he remembered from earlier visits as “just like Mayberry.”

“There were only two places I wanted to be,” he says. “Right beside a hospital emergency room or next to a Wal-Mart—both places people have to go.” He found a vacant office next to the Tifton ER and set up shop, settling his wife and children in Tifton in their 42-foot motor home, where they lived for the next year.

After a few months, Young realized his fledgling facility was going to succeed, and he accepted an offer to establish an office in nearby Albany, where he rented space from physicians.

That venture also went well, and he eventually bought his own building in Albany.

Young opened his third, and final, facility in Macon after the year-long non-compete agreement expired. The family moved back to their home, and the Macon facility became Young’s main office. He sees patients in Macon on Mondays and Fridays, in Tifton on Tuesdays, and in Albany on Thursdays, reserving Wednesday as a “floater” day.

THE NEW QUICK RELEASE DOBBS BAR Now it is easier than ever to get children in and out of their clubfoot brace. Just put the open-toe shoes on the child's feet and click them into place on our new Quick Release Dobbs Bar.

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Lets children kick and move their legs independently while maintaining abduction.

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Independent motion makes it harder to pull out of shoes and reduces irritation

The Dobbs Bar lets children move and kick their legs independently, which gives them more freedom of movement in their foot abduction brace.

Non-Compliance with foot abduction bracing in children treated with the Ponseti Method, is the leading risk factor for relapse and deformity recurrence.

Dr. Matthew Dobbs, a pediatric orthopedic surgeon who specializes in clubfeet at St. Louis Children's Hospital, set out to increase patient compliance by making a foot abduction brace that is easier to wear, allows the child to kick and crawl, and still maintains abduction. Parents of clubfoot children everywhere are praising his new brace, patented as the “Dobbs Bar”.

Stock Number: 270 AJQ Available in sizes-7-9” and 9-14” Suggested L Codes: Quick Release Dobbs Bar - L2300 & L2768 Markell Open-Toe Boots – L3204

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halls at the hospital or wine and dine the doctors. We’ve been running TV spots for about five years, and that, along with our reputation and word of mouth, keeps us busy.”

The clinic primarily treats geriatric patients, most of whom have suffered amputations as the result of peripheral vascular problems associated with diabetes.

Personal Care

Same-Day Service Young is the sole practitioner at the Amputee Prosthetic Clinic. His wife serves as office manager and handles all scheduling, billing, and insurance functions with the help of another office administrator based in Tifton. All devices are fabricated by staff technician Chason Stavely, CTPO, and Young, who had eight years of technician experience before becoming a certified prosthetist. The Macon office has the most well-equipped lab, but all three offices have fabrication capabilities.

The clinic prides itself on providing

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O&P ALMANAC JUNE 2011

same-day service whenever possible.

“Our process allows us to deliver devices in hours,” says Young. “Last week, I saw a transtibial amputee in the morning, and he walked out of here at noon. We dedicate time and effort to one project, finish it, and then move on to the next. So unless it’s something super sophisticated, like a Utah arm, patients leave with a device the same day they come in.”

Although Amputee Prosthetic Clinic is not without competition—”the market is saturated,” says Young—he isn’t worried. “I’m OK being the second guy,” he says. “I don’t stalk the

Young, who has been an above-knee amputee since 1991, was inspired to go into the field after a bad experience with his first prosthetist.

“He wouldn’t listen to me,” Young recalls. “If he had just listened, my problem would have been solved, and his job would have been a lot easier.

The next prosthetist I went to used appropriate technology, and I was walking in short order.”

That encounter motivates Young to pay attention to his patients. “I’m a better than average listener,” he says.

“And the job’s a lot easier if you listen.

We have to treat each patient as if we don’t know anything. You can’t learn anything if you think you already know it.”

Young has no plans to expand beyond his three offices. “I fight expanding like crazy. I know people who want to dominate the region, but I’m into personal care,” he says. “I want to get to know my patients, and I don’t want 95 employees and the headaches that come with that.”

His offices reflect that attitude: “We don’t want the place to look like just another doctor’s office. Most of our patients have seen so many doctors they don’t want that. So we have brightly colored paint, homey curtains, and touches that make the place a little different.” a Deborah Conn is a contributing writer to O&P Almanac. Reach her at debconn@ cox.net.

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AOPA Headlines AOPA WORKING FOR YOU

Investing in the Real Future

Y

oung people coming into the field represent the greatest hope for the future of every O&P practice.

Many AOPA member companies are now into their third or fourth generation of ownership. They may be celebrating 50 or 100 years in the field, but they still need to keep one eye focused on the source of worthy successors to current practitioners.

That’s why an important initiative growing out of AOPA’s 2008 strategic planning effort is developing closer relationships with teaching institutions accredited by the National Commission on Orthotic and Prosthetic Education (NCOPE).

This initiative acknowledges that AOPA must reach out and become known as an organization rich in resources for those 200 or so graduates each year who go on to residency programs and then become employees in patient-care facilities—and someday perhaps owners of those facilities.

This effort, led by AOPA Board Member Russ Hornfisher, initially focused on how AOPA could help identify whether adjustments were needed to the curriculum to make sure that the skills and talents taught are indeed the skills and talents needed in the real world of O&P. It became clear early on that educators yearned for a helpmate in teaching real-world experiences and enthusiastically embraced the AOPA effort. A first step was to confer a special AOPA membership status on these institutions and provide a variety of AOPA education resources, publications, services, and other tools to assist the learning process.

Learning Tools AOPA donated subscriptions to AOPA In Advance, the O&P Almanac, and audio conferences to member institutions and facilitated access to the Mastering Medicare Webcasts.

These resources all contribute to a platform of learning and understanding for the practitioners of tomorrow.

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O&P ALMANAC JUNE 2011

AOPA’s partnership with the Center for O&P Learning

Another important learning tool is the Business Optimizing Analysis Tool (BOAT), which includes four necessary and significant areas of business management information, ranging from financial management and budgeting to market and competitive analysis and practice management.

The practice management section of BOAT, for example, includes a self-evaluation tool that enables patient-care facilities to score their efficiency in almost every area of the business.

Areas included range from coding capability to collections to patient care factors such as patient processing, diagnosis, charting, and measuring patient satisfaction. More than one educator has taken elements of this section and turned it into the curriculum for facility management education.

Still another resource is LCodeSearch.com. Not only does this website provide needed coding information to AOPA members 24/7, but in the hands of a skilled educator, it has become a wonderful means for making sure the practitioners of tomorrow have a basic understanding of the billing and reimbursement process that is vital to delivering quality patient care.

Combine LCodeSearch.com with AOPA’s Illustrated Guide and Coding Pro, and these young professional begin their careers with a body of knowledge about reimbursements— one of the most complex O&P areas to master—with tools that simply weren’t available just a few years ago.

More learning tools are available to these students through the clinical and business management presentations that were captured on video at AOPA’s National Assembly. Videos are posted at www.AOPAnetonline.org/education. These presentations are also still available to AOPA members and their employees for a limited time at no cost. Many presentations can earn enrollees up to one and one half continuing education credits by earning a score of 80 percent on a short quiz.

Networking Opportunities To further build rapport with the educators and schools, Hornfisher hosts an educators luncheon during the National Assembly each year. In addition, AOPA, the American Board for Certification in Orthotics, Prosthetics & Pedorthics, and the American Academy of Orthotists and Prosthetists contributed $5,000 each to fund a two-day educators’ retreat this past year.

Participants at the retreat could exchange best practices, compare curricula, and learn more about the readily available resources from the three organizations that can support their learning curve. Many recalled a well-received earlier AOPA program in which three or four board members volunteered their time and visited several of the schools. The visits consisted of a formal lecture by the board member, informal discussion, and a freewheeling question and answer period.

The current board volunteered for a similar program, which was launched earlier this year. Each institution now has an AOPA board liaison who will visit twice a year and be available to answer real-world questions throughout the year. An operating guide spells out available resources and how they are accessed. At the Sept. 19-22, 2011, National Assembly, the board liaisons will have a more formal get-together with the school administrators and instructors.

AOPA isn’t trying to mimic the famous McDonald’s formula that drove the company’s brand-building strategy by advertising on children’s TV programs 50 years ago. But it’s no secret that millions who were toddlers in those days developed an adult loyalty to the Golden Arches long before many other brands influenced their buying decisions.

There is a lesson for O&P in that scenario, and the AOPA Board had the foresight to recognize it. If AOPA steps up and truly supports and enhances the education and subsequent career growth of today’s O&P students, AOPA too may earn lasting respect and recognition in the hearts and minds of these practitioners of tomorrow. a

SILVER SPONSORS

BRONZE SPONSORS

AOPA thanks the 2011 Policy Forum Sponsors for their vital support of this

SUPPORTERS

important O&P event.

Find out how you can support the 2012 AOPA Policy Forum, call Kelly O’Neill at 571/431-0852.

JUNE 2011 O&P ALMANAC

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AOPA Headlines

Preventing Medicare Audit Disasters Having your claims audited can be a stressful and intimidating experience. Small errors or omissions can cost even the most compliant providers valuable assets due to refund requests and further audits.

The June 8 AOPAversity Mastering Medicare Audio Conference, “Preventing Audit Disasters” will provide you with guidance on how to minimize the impact of claim audits on your organization. Discussion topics include ½½ proper documentation techniques ½½ responses to an audit request ½½ techniques to minimize potential exposure during an audit ½½ tips for correcting errors discovered during an audit ½½ internal audit techniques.

The cost of participating is always just $99 per line for AOPA members ($199 for nonmenbers) and any number of employees may listen on a given line. Listeners can earn 1.5 continuing education credits by returning the provided quiz within 30 days and scoring at least 80 percent.

Contact Devon Bernard at dbernard@AOPAnet.org or 571/431-0854 with content questions.

Register online at https://aopa.wufuu.com/forms/2011telephone-audio-conferences/. Contact Ann Davis at adavis@ AOPAnet.org or 571/431-0876 with registration questions.

O&P Almanac COMING NEXT ISSUE

Trends in Lower Limb Prosthetics

Watch your mail for the July 2011 issue!

For more information about the O&P Almanac and other AOPA publications, visit us online at www.AOPAnet.org.

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O&P ALMANAC JUNE 2011

States Introduce Bills Opposing Pharmacy Employees Dispensing Custom Foot Orthoses to Diabetics State community pharmacist organizations introduced bills in the Kentucky and Illinois legislatures (both licensure states) to amend licensing laws to permit untrained pharmacy employees to prescribe and dispense therapeutic shoes and custom foot orthoses to at-risk diabetic patients.

O&P practitioners in these states have emphasized to legislators that diabetic patients could be at risk by ending pharmacy employees’ requirement for professional health education and training as a prerequisite to treat these patients. Proponents of this bill have cited the National Community Pharmacists Association (NCPA) as a source of this initiative. If this issue is a priority of the NCPA, it is possible that similar legislation will be promoted in all states.

In states without O&P licensure laws or retained lobbyists, these proposals could slip under the radar, and the O&P community might only find out about it after the law is passed. Most states have a comprehensive legislative site, and AOPA members can search to see if similar bills are pending.

Materials related to the Illinois bill are available online: to read a synopsis of the bill visit www.aopanet. org/Illinois_Pharmacists_Bill_Synopsis.pdf; to read the text of the bill visit www.aopanet.org/Illinois_ Pharmacists_Bill_Text.pdf; to read an analysis of the Illinois bill visit www.aopanet.org/Illinois_Pharmacists_ Bill_Analysis.pdf.

Contact Steven Rybicki at srybicki@AOPAnet.org or 571/431-0835 if you discover that this legislation is being promoted in your state.

We were with Beth.

Every step of her way.

JUST LIKE YOU Beth Davis, CMF co-owns Just Like You, one of the many BOCaccredited facilities making a difference to their patients every day.

Background: Beth and her mother opened Just Like You in 1997. Beth worked there part-time until graduating from Louisiana Tech.

Impact: With Susan G. Komen Breast Cancer Foundation support, Beth co-founded a program to provide no-cost care to uninsured or underinsured breast cancer survivors.

Service: Beth’s commitment to service doesn’t end at Just Like You. She has been selected to serve on major manufacturers’ retail advisory panels, where she shares her industry knowledge.

“

I cannot imagine navigating this field without BOC. I count on BOC to make sure that we are not only in compliance with all regulations, but that we have the training and support to achieve our goals.

”

BOC is proud to have been a part of Just Like You’s success.

You can count on BOC during your journey, too.

www.BOCusa.org/profiles

O&P Certification

877.776.2200 | 410.581.6222

DMEPOS Accreditation

n

AOPA Headlines O&P PAC News The O&P PAC would like to acknowledge and thank the following AOPA members for their recent contributions to and support of the O&P PAC*:

Sherrie Anderson, CP Robert Arbogast Stephen A. Blackwell, CPO, LPO Maynard Carkhuff Marty Carlson, CPO Mary Charton James Claiborne, CPO Fred Crawford Heather Davidson, CO Thomas V. DiBello, CO, FAAOP Kathy Dodson Kathleen Easterbrooks Robert Easterbrooks, CPO

Rick Fleetwood, MPA Ed Gildehaus III, CPO, C.Ped, FAAOP M. Kale Hinnant, CP, FAAOP James Hughes, CP, LP James Kaiser, CP Ronald G. Lanquist, CO Jon Leimkuehler, CPO, FAAOP Robert V. Leimkuehler, CPO Eileen Levis Anita Liberman-Lampear, MA Randall L. Ludolph, CP Mark Maguire, CPO

Clyde Newton Massey, CPO Brad Mattear, CFo Tina Moran Eric Neufeld, CPO Ronald W. Pawlowski, CPO Mark A. Porth, CPO, FAAOP Joshua Schenkman Mark W. Smith, CP Donald Virostek, CPO, LPO Ed and Ashlie White James Young, CP, LP, FAAOP Claudia Zacharias, MBA, CAE

The O&P PAC would also like to acknowledge and thank the following AOPA members for their recent O&P PAC contributions to the sponsored fundraiser for Congressman Wally Herger (R-California): Ryan Arbogast Kel Bergmann, CPO Stephen Blackwell, CPO, FAAOP Frank Bostock, CO, FAAOP Maynard Carkhuff Fred Crawford Glenn Crumpton, CPO, C.Ped Charles Dankmeyer, Jr., CPO Thomas V. DiBello, CO, FAAOP Deane Doty, CPO Robert Easterbrooks, Jr., CPO Rick Fleetwood Bert Harman James A. Kaiser, CP

Marc Karn, CP Mark Kirchner, CPO Thomas Kirk, PhD Michelle Koehler, CO Al Kritter, Jr., CPO, FAAOP Jon Leimkuehler, CPO Robert Morgan Ralph Nobbe, CPO Jeff Parsons, LO, CO Scott Schneider Chris Snell Clint Snell, CP Rick Stapleton, CPO Brian Steinberg, CO Frank Vero, CPO James Weber, MBA James O. Young, CP, FAAOP Past President of AOPA James Kaiser, CP, Amputee Coalition President and CEO Kendra Calhoun, and Rep. Wally Herger.

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O&P ALMANAC JUNE 2011

The O&P PAC advocates for legislative or political interests at the federal level that have an impact on the orthotic and prosthetic community. To achieve this goal, committee members work closely with members of the House and Senate to educate them about the issues, and help elect those individuals who support the orthotic and prosthetic community.

To participate in the O&P PAC, federal law mandates that you must first sign an authorization form. To obtain an authorization form, contact Devon Bernard at dbernard@AOPAnet.org. a *Due to publishing deadlines this list was created on April 19, 2011. Any donations received or made after April 19, 2011, will be published in the next issue of O&P Almanac.

Advanced Medicare Coding and Billing Seminar in Baltimore AOPA will host a Mastering Medicare: Advanced Coding and Billing Techniques seminar in San Antonio from June 15 and 16 at the Marriott River Center (room rate of $159 per night).

During this session, AOPA experts will provide O&P practitioners and office billing staff with up-to-date information about coding complex devices, including repairs and adjustments, through interactive discussions with experts and colleagues. This advanced two-day event will feature break-out sessions for practitioners and office staff to concentrate on group-appropriate materials.

The cost for seminar tuition is as follows: member (early registration) $525; nonmember (early registration) $725; member (later registration) $550; nonmember (later registration) $750. Additional attendees (more than one from the same office) cost: member (early registration) $475; nonmember (early registration) $675; member (later

registration) $500; nonmember (later registration) $700.

Contact Devon Bernard at dbernard@AOPAnet. org or 571/431-0854 with content questions.

Register online at https://aopa.wufoo.com/ forms/2011-mastering-medicare-san-antonio/.

A third session will be held on October 24 and 25 at the Sheraton Inner Harbor in Baltimore.

Register online at https://aopa.wufoo.com/ forms/2011-mastering-medicare-baltimore/.

Contact Ann Davis at adavis@AOPAnet.org or 571/4310876 with registration questions.

[Golf Classic [ Thranhardt

MONDAY, SEPT. 19, 2011 8:00 AM

Missed your invitation to play in the British Open? Not to worry. You can still play 18 of the best holes from 11 different British Open rotation courses, including two holes from this year’s British Open. Better still, they are all on one golf course located less than 9 miles from the heart of the Las Vegas Strip and the location of the 2011 AOPA National Assembly.

Don’t miss the 2011 Fall Thranhardt Golf Tournament—Two great causes and one great course make it not just golf, but a golf experience. For the third year in a row AOPA’s Capitol Connection and OPAF have joined forces to co-sponsor this great event to benefit the inspiring efforts of OPAF and the legislative, research and education efforts of the Capitol Connection to further the O&P policy agenda.

Individual Play $195; Foursome Play $750 Fee includes green fees, cart fees, practice balls and lunch.

Visit www.AOPAnet.org for more information.

JUNE 2011 O&P ALMANAC

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$

BUYERS’ GUIDE 2 011

The annual one-stop resource for O&P products and services

48

O&P ALMANAC JUNE 2011

contents

49 Orthoses and Components 49 Orthotics—All 49 Hip Orthoses 49 Ankle/Foot Orthoses-AFO 50 Knee Orthoses 50 Orthoses: Lower Limb 52 Pediatric Orthoses 52 Soft Goods/Orthotic 53 Spinal Orthoses

53 Prostheses and Components 53 Prosthetics—All 55 Lower Limb Prosthetics 55 Upper Extremity: Prosthetics 55 Feet 58 Foot Care: Custom Footwear 58 Prosthetic Components 58 Soft Goods/Prosthetics

59 Lab Equipment 59 Lab Equipment—All

60 Miscellaneous

60 Central Fabrication 61 Specialty O&P Distributors

61 Reference Materials and

Business Services

62 Comprehensive Index

ORTHOTICS—ALL

2011 BUYERS’ GUIDE

Orthoses and Components

Hosmer 800/827-0070 Campbell, CA www.hosmer.com customerservice@hosmer.com

OTS Corp.

Becker Oregon Albany, OR 541/967-1821 www.beckeroregoncatalog.com Becker Oregon began as Oregon Orthotic Systems (OOS), Inc. in 1990 as a company that introduced the principles of rotational control to lower limb laminated orthotics. Today, Becker Oregon is owned and operated by Becker Orthopedic as an independent, full-service, central fabrication facility on the west coast. Although Becker Oregon continues to offer rotational control laminated orthotics, the company has changed its focus to more traditional thermoplastic and metal & leather orthotic fabrication. Becker Oregon is committed to the highest standards of workmanship and unsurpassed service to the orthotic and prosthetic community.

Otto Bock HealthCare Minneapolis, MN 800/328-4058 www.ottobockus.com Otto Bock is your one-stop shop for the highest quality orthotics, superior technical support, and comprehensive education.

From advanced stance control technology to off-the-shelf orthotics, count on Otto Bock to meet all your patients’ needs. We offer a full range of prefabricated solutions following surgery or injury. Our custom-fabricated braces ensure your patients receive the support and stabilization they need. We also provide industry-leading, advanced Stance Control technology options for the highest level of function. You get the total package from us. Call your Otto Bock sales representative today at 800/328-4058 or visit www.ottobockus.com for the solutions you need.

Fillauer LLC 800/251-6398 Chattanooga, TN www.fillauer.com customerservice@fillauer.com

Center for Orthotics Design 800/346-4746 Campbell, CA www.centerfororthoticsdesign.com jcrowell@hosmer.com

800/221-4769 Weaverville, NC www.ots-corp.com info@ots-corp.com

HIP ORTHOSES

$

Allard USA Inc. Rockaway, NJ 888/678-6548 www.allardusa.com info@allardusa.com

ANKLE/FOOT ORTHOSES–AFO Allard USA Inc. Rockaway, NJ 888/678-6548 www.allardusa.com info@allardusa.com

Dynamic Walk Single Side by Centri®— New One-Year Warranty The Dynamic Walk Single Side Orthosis is a new AFO made of a lightweight moldable carbon fiber composite material. The open heel construction allows for optimal fit and comfort with various shoe types. The Dynamic Walk Single Side provides dorsiassist with subtalar inversion and eversion control. This high activity design enables freedom of motion and allows for walking, running, and climbing stairs.

Features Include: • Easy donning and doffing • High strength • Fits easily into regular and narrow shoes • Flexible for multi-plane action • Enables athletic activity such as moderate running • Choose between PEEK rods on medial or lateral side.

All Dynamic Walk models purchased in 2011 have a one year warranty.

Contact Fillauer LLC at 800/251-6398 or Hosmer at 800/827-0070.

JUNE 2011 O&P ALMANAC

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2011 BUYERS’ GUIDE

OPTEC USA—EZ Step™ Leather Ankle Gauntlet OPTEC’S EZ Step Leather Ankle Gauntlet continues the pattern of innovation and excellence catered to your needs. The EZ Step’s custom fabrication combines incomparable comfort with unparalleled control, helping to make each step easier than the last. Key features include: • Unsurpassed craftsmanship and professionalism • Premium leather outer shell with soft, comfortable, padded leather lining • Thin, durable, polymer ankle and foot stabilizer • Less bulky and rigid than traditional gauntlets • Multiple closure systems for easy donning and doffing.

For more information on OPTEC’S EZ-Step™ Leather Ankle Gauntlet or our other products, please call customer service at 888/982-8181 or visit us at www.optecusa.com.

$

KNEE ORTHOSES Allard USA Inc.

SPS Introduces BioniCare® Knee System to O&P BioniCare is a patented system with FDA approval (2003) as an adjunctive therapy for the treatment of pain, symptoms, and overall improvement of the osteoarthritic knee. The BioniCare system, distributed solely by SPS, delivers an imperceptible pulsed electrical signal that was designed to supplement the body’s endogenous electrical impulses required to maintain joint health. Published clinical studies demonstrate patients using the BioniCare system are two thirds less likely to have total knee replacement surgery. Clinical studies show that most patients will see significant improvement after 750 hours of use, with the greatest improvements achieved after 2,250 hours.

BioniCare’s clinically proven system is delivered through advanced technology electrodes that avoid the need for conductive gel. It is available with the OActive® brace to reduce pain in the knee by offloading pressure on the knee and a Night-Wrap System to facilitate nocturnal treatment.

For more information, contact SPS Customer Service at 800/767-7776 x 3.

O&P ALMANAC JUNE 2011

Allard USA Inc. Rockaway, NJ 888/678-6548 www.allardusa.com info@allardusa.com

Becker Orthopedic Becker Orthopedic is pleased to introduce a new modular series of knee joint, ankle joint, and upright options. Providing automatic locking (Model 1017) and ratchet locking (Model 1018) knee joints, this modular series will offer versatility and ease in the fabrication of your orthosis. Our new Modular Double Action Ankle Joints and Standard Action Ankle Joints are available with either a 3/4 in. or 5/8 in. recess to accommodate our A & B size modular knee joint uprights. Lamination uprights are also available to assist with your fabrication.

For more information, please call 800/521-2192 or visit our website at www.BeckerOrthopedic.com.

Extension Assist or Locking Knee—You Decide

Rockaway, NJ 888/678-6548 www.allardusa.com info@allardusa.com

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ORTHOSES: LOWER LIMB

PEL Supply now offers the GXL-Knee (GX-Locking Knee) from Becker Orthopedic.

This knee incorporates the best features of both the Key Lock™ (1015) and GX-Knee (9000) knee joints. Integrating the extension assist feature of the GX-Knee with the desirable locking mechanism of the Key Lock gives you and your patient a whole new level of confidence and convenience. According to Becker, Model 9015 is a free-motion knee joint that is designed to provide extension assist, not prevent knee flexion. In addition, the GXL-Knee has the option of locking at full extension for use as a locked knee joint. Switching between “free motion” with extension assist to “lock” is performed by simply rotating the Key Locks.

For more information on the GXL or any of Becker’s high quality, innovative orthotic components, please call your friendly PEL Supply customer service rep at 800/321-1264, fax your order to 800/222-6176, or email customerservice@ pelsupply.com. Registered customers may order online at www.pelsupply.com.

EEZZFFlex lex L Liner iner

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Liner AlpsAlps NewNew EZ EZ FlexFlex Liner (anterior shown (anterior viewview shown above) is available above) is available in in 3mm or 6mm Uniform 3mm or 6mm Uniform thicknesses.

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Antioxidants & EZ Antioxidants & EZ GelGel Protect Skin-Protect Skin--

Antioxidants EZhelp Gel help Antioxidants in EZin Gel protect the from skin from damage protect the skin damage caused by radicals. free radicals. caused by free is perfect for those ALPS ALPS EZGelEZGel is perfect for those skin characteristics with with poor poor skin characteristics or sensitive tissues. or sensitive tissues.

Budget Friendly-Budget Friendly--

No other onmarket the market No other liner liner on the provides this quality, durability provides this quality, durability and functionality at price... this price... and functionality at this absolutely no other! absolutely no other!

800.574.5426 800.574.5426 www.easyliner.com www.easyliner.com info@easyliner.com info@easyliner.com

2011 BUYERS’ GUIDE

Fabricate a custom KAFO in less than an hour!

PEL Supply offers a low profile, functional orthotic solution for management of genu-recurvatum combined with footdrop. ToeOFF®, from Allard USA, has proven to be an effective gait rehabilitation orthosis for the management of footdrop and ankle instability. Too often, however, footdrop is accompanied by genu-recurvatum, or chronic knee instability. The new Combo, available from PEL Supply, is a lightweight, removable knee brace attachment for ToeOFF® (or BlueRocker™) that creates an innovative orthotic solution for the management of this condition. Features of the Combo: • Uprights easily shaped and adjusted to optimum height for patient • Modular components accommodate variances in thigh and calf circumferences • Low profile • Lightweight • Easy to don and doff • Easily removed when wearer is relaxing (watching TV, etc.)

• Sold individually.

For more information on the Combo, and other quality products from Allard USA, call your friendly PEL Customer Service Rep at 800/321-1264, fax 800/222-6176, email customerservice@pelsupply.com, or order online at www. pelsupply.com.

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Spinal Technology’s Expertise in Lower Limb Technology & Prosthetics Spinal Technology, Inc. takes its excellence in product quality and service and brings them to Lower Limb Orthotics and Prosthetics. With our unparalleled customer service, experienced technicians and certified orthotists, we offer custom-made lower extremity orthotics and prosthetics with emphasis on high-quality craftsmanship. For more information on our Lower Limb products and Prosthetics, call 800/253-7868 or email us at info@spinaltech.com.

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PEDIATRIC ORTHOSES Allard USA Inc. Rockaway, NJ 888/678-6548 www.allardusa.com info@allardusa.com

Fillauer LLC: Fillauer II Standing Frame The Fillauer II Standing Frame is an adjustable metal exoskeleton attached to a stable base of support that allows the child crutch-less, hands free standing. While supported in the Fillauer II Standing Frame, the child gains all the physiologic benefits of standing along with the ability to use their hands to explore their environment.

• Easy to assemble kit • Custom fit to child • Accommodates for growth • Allows for hands free activities • Useful as training tool for progression to other assistive devices • Recommended for ages 1-3 years.

For more information, call Fillauer LLC at 800/251-6398 or visit www.fillauer.com.

SOFT GOODS/ORTHOTIC Knit-Rite Orthotic Textiles Knit-Rite’s Orthotic Textile Interfaces offer patients comfort and protection in their everyday lives. We are proud to offer products including patented SmartKnit Seamless AFO and KAFO socks, Torso Interfaces®, cranial interfaces, fracture inter-faces, SmartKnit® and Therasock® Diabetic Socks, and a full line of Therafirm® Gradient Compression Hosiery and Core-Spun

by Therafirm™ Support Socks.

For more information, contact Knit-Rite at 800/821-3094 or email customer-service@knitrite.com.

Allard USA Inc. Rockaway, NJ 888/678-6548 www.allardusa.com info@allardusa.com

2011 2011 BUYERS’ BUYERS’ GUIDE GUIDE

SPINAL ORTHOSES

Prostheses and Components PROSTHETICS—ALL

OPTEC USA’s Stealth PRO – PDAC Approved L0631 OPTEC is proud to present our new Stealth PRO, which is ideal for patients requiring firm support. The Stealth’s revolutionary intercrossing strapping system, along with the anterior opening design, combines with a rigid back panel to provide spinal stabilization from the sacrococcygeal junction to T9 vertebra. The Stealth PRO back panel attaches to the Stealth brace with our secure elastic suspender, which ensures the same fit every time with no rotation of either component when donning. PDAC recently approved both the Stealth PRO2 and Stealth PRO4 for HCPCS code L0631.

Find out more about this and our many other products online at www.optecusa.com or call us today at 888/9828181!

Spinal Technology’s Flex-Foam® The FlexFoam® Spinal Orthosis from Spinal Technology, Inc. offers a patented design that combines the rigidity of a traditional TLSO with the comfort of a soft brace. This product is designed specifically for patients who have a low tolerance for rigid, full contact orthoses. The FlexFoam® is fabricated with two layers of varying densities of foam to provide both comfort and control. An external thermoplastic shell is incorporated to provide additional support and correction where indicated. The orthosis can be fabricated with a single opening or bi-valve. It can be custom fit to measurement or cast.

For more information, call 800/253-7868 or visit www.

SpinalTech.com.

ARTech Laboratory, Inc. Midlothian, TX 888/775-5501 www.artechlab-prosthetics.com The loss of a limb causes deep emotional trauma. Apart from the obvious difficulties with mobility and self-care, the disturbance in body image requires significant emotional readjustment. Our objective is to eliminate the stigma associated with the disfigurement. As opposed to the robotic or mannequin look of traditional prosthesis, our restorations have a natural appearance since they are sculpted and painted to match the opposite limb. Without close examination, ARTech’s prostheses are virtually undetectable.

It is our privilege to work in an industry that gives selfsufficiency, mobility, and self confidence back to those with amputations and birth defects. For more information, call 800/775-5501 or visit www.artechlab-prosthetics.com.

$

Fillauer LLC 800/251-6398 Chattanooga, TN www.fillauer.com customerservice@fillauer.com

Hosmer 800/827-0070 Campbell, CA www.hosmer.com customerservice@hosmer.com

Motion Control Salt Lake City, UT www.utaharm.com info@utaharm.com

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2011 BUYERS’ GUIDE

Otto Bock HealthCare Minneapolis, MN 800/328-4058 www.ottobockus.com You’ve counted on Otto Bock HealthCare’s high-quality prosthetic products and services to provide functional, reliable technology for your patients. That’s what’s made the C-Leg® the standard in transfemoral fittings. Continue to give your customers increased mobility, confidence, and independence with Otto Bock’s precisely fitted solutions, suitable for even for the most demanding situations, for every level of function and amputation. Your prosthetic fitting goal is to provide the best possible outcome for your patient. Our individualized solutions fit every lifestyle and will help you give your patients the quality of life they deserve.

Call 800/328-4058 or visit www.ottobockus.com.

$

SPS Stocks bebionic v2 Hands Combining ease of control with elegance of design, the bebionic v2 hands are available in medium and large sizes with major improvements to speed, accuracy, grip, and durability. In stock at SPS, the bebionic v.2 hands feature: • Upgraded individual motors for significantly higher operating speeds • Additional grip patterns including the unique mouse grip, trigger grip, precision grip, and improved tripod grip • Redesigned Radio Frequency Board has been redesigned and integrated within the hand to optimize the convenience of wireless programming • Soft finger palps provide enhanced gripping capabilities of each digit • Wider Thumb profile—increases the gripping surface.

SPS is offering a series of full-day Myoelectric Hand training courses including the new bebionic hands at various sites around the country.

Please call Kim Martin at 800/767-7776 x 173 or register online at www.spsco.com.

SPS Stocks Pulse Hand and Touch Bionics Electrode The Pulse hand is the latest addition to the i-LIMB family and is so named because of its pulsing grip, providing greater grip strength than previous i-LIMB models.

• Unique pulsing grip strength is variable and selectable per digit.

• BIoSim Professional software embedded in the Pulse Hand allows real-time assessments and control. Must be fully accredited to utilize.

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O&P ALMANAC JUNE 2011

• New aluminum chassis, knuckles, and dislocators increase the strength beyond earlier i-LIMB models • Proportional speed allows Pulse hand to respond based on the strength of the input signal • Two sizes available—small and medium • Two colors available—black and natural • Two cover options—i-LIMB Skin or new Dynamic Flex Cover.

Touch Bionic’s new electrode ships complete with all components required to manufacture both laminated and thermoplastic inner socket options. The high frequency shielding and filtering minimizes the effects of electromagnetic interference.

For more information, contact SPS Customer Service at 800/767-7776 x 3.

Enhanced Savings on Freedom Feet with Plié 2.0 MPC Purchase from SPS Through the end of June 2011, any SPS purchase of a Plié 2.0 MPC Knee will qualify you to receive a FREE Freedom Series™ prosthetic foot (includes Pacifica®, Pacifica LP, Highlander®, or Sierra® Foot) and a FREE Foot Shell. Alternatively, you may choose a Freedom Vertical Shock* Foot Product for 50 percent off list price plus a FREE Foot Shell with your SPS purchase of a Plié 2.0 MPC Knee. *All Renegade® and Silhouette® models as well as the Thrive™ prosthetic foot are eligible under this limited time promotion. Plié 2.0 MPC Knee has synergistic microprocessor and hydraulic technologies that deliver a highly responsive prosthetic knee, while facilitating natural and intuitive mobility. Plié’s Set-Up Wizard guides you through the fitting process step-by-step to ensure successful outcomes irrespective of whether you fit a Plié knee yesterday or last month.

For more information, contact SPS Customer Service at 800/767-7776 x 3.

Willow Wood Mt. Sterling, OH 800/848-4930 www.willowwoodco.com For over a century, Willow Wood has worked closely with clinicians to create strong relationships built on caring and trust. We do more than create exceptional prosthetic products. We want to ensure that everyone we work with and everyone we ultimately serve finds the prosthetic fit that frees the body and the spirit. Our OMEGA Tracer CAD System equips clinicians to create numerous O&P devices.

Our products, including Alpha® Liners, LimbLogic® VS, and a full line of prosthetic feet, help clinicians build prostheses that deliver mobility, comfort, and range of motion.

For more information, call 800/848-4930 or view our complete product line at www.willowwoodco.com.

Fillauer LLC: REL-K Microprocessor Knee System The REL-K (Rizzoli Electronic Knee) is the latest generation of microprocessor knees which promises amputees the ability and freedom to navigate their environment simply and easily. With its innovative sensor system that samples angular position, velocity and knee loads at 1,000 times per second, the REL-K instantly works in concert with the patient and adjusts itself for optimum performance. Since the control system is located entirely in the knee, most foot and pylon combinations can be used.

Unlike other systems that restrict ankle and foot combinations, the REL-K is adaptable to a variety of systems. The knee’s composite frame was developed by Italian sports car designers for high-strength and cosmetic appeal. The hydraulic unit evolved from a design used in F1 racing for speed and accuracy of control. The REL-K is rated for patients up to 220 lbs/ 100 kg.

For more information, contact Fillauer LLC at 800/2516398 or visit www.fillauer.com.

Spinal Technology’s Expertise in Lower Limb Technology & Prosthetics Spinal Technology, Inc. takes its excellence in product quality and service and brings them to Lower Limb Orthotics and Prosthetics. With our unparalleled customer service, experienced technicians, and certified orthotists, we offer custom-made lower extremity orthotics and prosthetics with emphasis on high-quality craftsmanship.

For more information on our Lower Limb products and Prosthetics, call 800/253-7868, or email us at info@spin altech.com.

2011 2011 BUYERS’ BUYERS’ GUIDE GUIDE

LOWER LIMB PROSTHETICS

UPPER EXTREMITY: PROSTHETICS Regal Gloves from Hosmer Regal Gloves are high-definition silicone cosmetic covers that offer patients a realistic appearance that will bring them confidence, pride, and comfort. Regal Cosmetic covers offer increased product longevity and durability.

Features and benefits include: • High-definition appearance with intrinsic pigmentation • Stain-resistant silicone • Easy-to-clean with soap and water • Wide variety of sizes, styles, colors and options available • X series adds a more detailed look to nails as well as added pigmentation and shading to the hand and knuckles; available with hair implanted in fingers.

For more information, call Hosmer at 800/827-0070 or visit www.hosmer.com.

Texas Assistive Devices LLC Brazoria, TX 800/532-6840 www.n-abler.org hps@n-abler.org

$

FEET Accent Your Life with College Park The Accent® foot from College Park provides a service-free option for individuals who desire a cosmetically appealing foot with an easy-to-adjust heel height. A simple push of a button provides the wearer their choice of footwear. Features include: • 2 in. (51 mm) user-adjustable heel height • Dynamic pylon and integrated pyramid options • Ankle fairing for superior finishing • Sandal-toe foot shell, with narrow and wide width options • Service-free • Three firmness choices.

For more information, call 800/728-7950 or visit www. college-park.com.

JUNE 2011 O&P ALMANAC

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2011 BUYERS’ GUIDE

The new PROPRIO FOOT® with EVO™ by ÖSSUR—Stable, Smooth, and Comfortable

TM

FOOT SYSTEM

FOOT SYSTEM

TM

Emotis Family of Feet Emotis’s variety of foot systems, developed with advanced composite materials, range from all-purpose to high-performance. The Element Foot System sets itself apart from two-spring prosthetic foot designs by adding an innovative third element providing unsurpassed smoothness, stability, and performance throughout the gait cycle.

The ElementDS combines the Element Foot System and the DuraShock to create a foot system that produces incredibly smooth rollover and increased vertical shock absorption.

The Ibex Foot System integrates innovative micro-slices in the pylon and a split heel plate that provides controlled inversion/eversion for terrain conformance. Also available, the Ibex XD, weighted for patients up to 440 lbs. The latest addition to the Emotis Foot line, the Wave Sport Foot System, provides active amputees the ability to engage in extreme sports to light jogging. The Wave Sport uses an innovative wave spring between the pylon and heel plate to provide shock absorption and stability.

Distributed by Fillauer LLC. For more information, call 800/251-6398 or visit www.fillauer.com.

$

Motion Control— Motion Foot The Motion Foot is a unique hydraulic foot and ankle system with a natural-range of ankle movement. Fully adjustable for nearly all levels of activity, the manual lock prevents unwanted movement in situations like driving, climbing ladders, or putting on shoes.

Features: • Independent plantarflexion and dorsiflexion hydraulic resistance adjustments to match patient preferences.

• Adjustable toe stiffness • Ankle locks at neutral for convenient driving and dressing.

• Adjustable toe lift (dorsiflexion stop) for those who want an easier time going up hills.

• Sizes 22-30 cm; Weight limit of 220 lb (100 kg) • Two-year warranty.

For more information, contact Motion Control at 888/6962767 or visit www.utaharm.com.

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O&P ALMANAC JUNE 2011

The newly redesigned PROPRIO FOOT with EVO utilizes intelligent ankle flexion to help users walk confidently and naturally without watching the ground, so they don’t need to think about every step for fear of tripping and falling. The lifelike ankle movement enables the PROPRIO FOOT to adjust for normal sitting and standing, and features automatic alignment for adapting to various types of footwear. PROPRIO FOOT recently received the prestigious Red Dot International Design Award over more than 4,000 submissions from 60 nations. Suggested Medicare assigned billing code is L-5973.

For more information, call 800/233-6263 or visit Össur at www.ossur.com.

For unmatched vertical shock and rotation try Össur’s NEW Re-Flex Rotate™ today!

Re-Flex Rotate with EVO boasts the most vertical travel of any vertical shock and rotation foot on the market today. A titanium spring provides over half inch of vertical travel and gives the foot a lightweight, responsive feel. Torsion cell technology provides smooth, progressive rotation with no abrupt stops. The EVO feature promotes a smoother, more comfortable rollover while increasing stability in stance. This unmatched combination makes Re-Flex Rotate the ideal solution for low to high impact patients who can benefit from vertical shock and rotation.

For more information, please visit www.ossur.com or call 800/233-6263.

New Flex-Foot® Talux® by ÖSSUR— Now with Sandal Toe The Flex-Foot Talux has been redesigned for ultimate durability, a great new look, and now features the sandal toe, which offers considerably more footwear options! Smooth or rough terrain, indoors and out, no other foot provides a more fluid, graceful walking gait. The Talux still includes the Tarsal Core and Achilles Strap, which provide multi-axial function, while the Dual J-Springs enhance forward motion, giving users ideal proportions of balance and agility. Try one today!

For more information, call 800/233-6263 or visit Össur at www.ossur.com.

Lower Limb Technology A division of Spinal Technology, Inc.

Your one source for expertise.

KAFO

Spinal Technology, Inc. now brings 20 years of expertise as a leader in central fabrication in the orthotic community to lower and upper extremity fabrication.

Lower Limb Technology manufactures superior custom orthotics and prosthetics. Our ABC Certified staff Orthotists / Prosthetists collaborate with highly skilled, experienced technicians to provide the highest quality products in the industry, as well as unparalleled service & support to you, our customer.

Call Us.

FO

AFO

800 253 7868 888 775 0588 /Fax spinaltech.com

191 Mid Tech Drive West Yarmouth, MA 02673 508 775 0990 888 775 0588/Fax

2011 BUYERS’ GUIDE

Willow Wood’s Fusion Foot Delivers Performance Mt. Sterling, OH 800/848-4930 www.willowwoodco.com With high performance in vertical shock absorption, heel-to-toe transition, and inversion and eversion, the Fusion™ Foot is an entirely new way to offer function without compromise. The integrated design permits the foot’s carbon fiber shank, heel, and foot plate to work together through each step. Clinicians may select one of three proximal adapters, including a torsion receiver.

The foot has field-adjustable trim height, heel stiffness, and inversion/eversion. A 36-month warranty comes standard with the Fusion Foot as does a full-height, high-activity foot shell.

For more information, call 800/848-4930 or visit www. willowwoodco.com.

$

FOOT CARE: CUSTOM FOOTWARE Apis Footwear Company 2239 Tyler Ave., Suite B El Monte, CA 91733 888/937-2747 www.apisfootwear.com Apis is devoted to offering our customers high quality, genuine leather Diabetic/Therapeutic footwear off the shelf or custommade, comfortable accommodative orthotics custom made for your patient using top quality materials, value added services include guaranteed fit for custom-made shoes, shoe modification services, free foam boxes, free samples and no-hassle return policy, large inventory, and quick turnaround. Together with your support and our continuous efforts, Apis Footwear Company is striving to become onestop shop for all your therapeutic footwear needs.

Please call our friendly customer service at 888/9372747, or visit www.bignwideshoes.com.

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PROSTHETIC COMPONENTS Euro International’s Rotation Adapter 10A15/S Euro International is excited to present another high quality product: the new Rotation Adapter 10A15/S. This adapter is absolutely maintenance-free and guarantees permanent backlashfreedom due to its new locking mechanism—even under continuously high and changing loads! With the Rotation Adapter, swiveling the lower leg is possible in flexion as well as in extension making frequent, everyday motions such as putting on shoes or getting in and out of cars considerably easier. Technical data: • Material: Stainless Steel • Maximum load: 150 kg • Mounting height: 26 mm • Component weight: 193 g • Rotation: 360°; automatically snaps back into original position.

For more information, call 800/ 378-2480 or visit www. eurointl.com.

SOFT GOODS/PROSTHETICS Comfort Products, Inc.—Complete Line of Prosthetic Socks The Comfort Products tradition lives on in the latest advancements in fiber technology with the finest knitting equipment available.

Throughout the years, we have become the Innovation Leader in Knitted Orthotic and Prosthetic Products.

Our innovations include: • First to incorporate X-Static® silver yarn into products for Orthotics & Prosthetics • First to offer a Seamless Diabetic Sock • First to marry X-Static® silver yarn with CoolMax® fabric • Developed and introduced SpectraCarb™, a unique lamination stockinette that combines Spectra Fibers and Carbon.

We are committed to providing the best knitted products with the latest innovations and highest quality for wearers of orthotic and prosthetic devices. We believe that this commitment is unparalleled in the world of orthotic and prosthetic knitted goods today. With our full line of Prosthetic Socks, we have something for everyone!

For more information, contact Comfort Products at 800/822-7500 or www.comfortoandp.com.

Improve your patient’s lives with Knit-Rite Prosthetic Textiles.

Through dedicated focus on textile research and working with practitioners, Knit-Rite continues to advance textile solutions that promote mobility, protection, and comfort. We offer a complete selection of high-quality and effective products, including a variety of prosthetic socks, prosthetic sheaths, prosthetic shrinkers, lower extremity suspension products, and fitting socks with established brands of Soft-Sock®, X-Wool,® A-Plus™, Original Compressogrip®, Power Belt, and LinerLiner®.

For more information contact Knit-Rite at 800/821-3094 or email customerservice@knitrite.com.

New ALPS Extreme Liner and Sleeve from PEL Supply The Alps Extreme Locking or Cushion Liner and the Extreme Sleeve have been specifically designed for either transfemoral (AK) or active transtibial (BK) amputees.

They eliminate 80 percent of vertical stretch, resulting in increased contact while stabilizing movement of redundant tissue. Both feature Alps’ new GripGEL™ to gently but firmly support the residual limb and sensitive tissues. Liners are available in 3 mm and 6 mm uniform thicknesses in eight sizes. The Extreme Sleeve seals against the skin without restricting circulation. GripGEL helps prevent the sleeve from rolling down the patient’s limb. It is available in 3 mm or 6 mm in sizes 20-70 cm. PEL Supply has over 50 years success as one of the nation’s largest independent wholesale distributors of high-quality orthotic and prosthetic products, components, tools, and accessories. PEL offers one-stop shopping/shipping convenience and same-day shipment on most popular items.

For information on the full line of Alps products, contact any helpful PEL customer service specialist at 800/3211264, by fax 800/222-6176, or email customerservice@ pelsupply.com. Order online at www.pelsupply.com.

2011 2011 BUYERS’ BUYERS’ GUIDE GUIDE

Knit-Rite Prosthetic Textiles

Lab Equipment LAB EQUIPMENT—ALL Fillauer LLC 800/251-6398 Chattanooga, TN www.fillauer.com customerservice@fillauer.com

Trautman Dual Bladder Vacuum Station by Fillauer LLC The Trautman Dual Bladder Vacuum Station allows for a variety of options in vacuum forming. The dual bladder configuration enables better mold preservation during vacuum forming and improved surface quality of the molded product. The station can be used as either a dual bladder or single bladder vacuum station.

• Durable, powder coated aluminum frame • High temperature, non-stick, clear silicone bladder • Dual bladder for use with Comfil® TFC and pre-preg materials • Quick change outer bladder saves time and money • Exterior dimension: 24 in. x 24 in.

• Requires vacuum source (2 connections for dual bladder setup).

For more information, contact Fillauer LLC at 800/2516398 or www.fillauer.com.

JUNE 2011 O&P ALMANAC

$

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2011 BUYERS’ GUIDE

Miscellaneous

OTS Corp.

800/221-4769 Weaverville, NC www.ots-corp.com info@ots-corp.com

CENTRAL FABRICATION OTS BT-4 Infrared Oven

$

60

Fillauer Companies Custom Fabrication

OTS is proud to introduce a new addition to the PDQ oven line, the BT-4 Infrared Oven. The BT-4 is capable of bubble forming and heating sheet plastic while taking up a minimal amount of floor space. The BT-4 Infrared Oven is big enough to heat most of your KAFO sheet plastic and has enough drop for even the biggest check socket, but it only takes up a corner space in your lab.

• Eight 1,000 watt emitters; four on top and four on bottom • Programmable digital temperature controller • Dual electric fans for air circulation • Four interior lights and large viewing window • Access point for vacuum line • Tray with fitted Teflon® cover for sheet plastic • 18 in. clearance for bubble forming.

For more information, contact OTS Corp. at 800/221-4769 or www.ots-corp.com.

Fillauer Companies’ fabrication facilities include: Fillauer LLC, Chattanooga, TN; Hosmer and Center for Orthotics Design, Campbell, CA; and OTS Corp., Weaverville, NC. With multiple fabrication facilities staffed with certified technicians, Fillauer prides itself in providing unsurpassed craftsmanship for all your custom fabrication needs ranging from myoelectric upper extremity to custom foot orthotics. We offer our customers the incomparable quality and service they have come to except from us. Providing the industry with more than 90 years of experience, Fillauer Companies’ fabrication facilities are here to serve you.

• Fillauer LLC 800/251-6398 or fax 423/698-6076 • Hosmer 800/827-0070 or fax 408/379-5263 • Center for Orthotics Design 800/346-4746 or fax 408/379-5126 • OTS Corp. 800/221-4769 or fax 828/658-8363

Hosmer

Otto Bock HealthCare

800/827-0070 Campbell, CA www.hosmer.com customerservice@hosmer.com

Minneapolis, MN 800/328-4058 www.ottobockus.com Whether your fabrication job is simple or complex, you want specialty facilities with the broadest range of services available, staffed by knowledgeable, caring people. That’s why Otto Bock Fabrication Services is a perfect partner for your business: We offer decades of expertise, exceptional customer service, and an unparalleled reputation for quality. Expertise in fabrication technologies is a given. And we also continually evaluate new materials and improve our processes to serve you better. You can count on the best results even with “temperamental” materials—our experts will give you exactly what you need.

Call 800/328-4058 or visit www.ottobockus.com.

O&P ALMANAC JUNE 2011

BREG, Inc. 2611 Commerce Way Vista, CA 92081 800/321-0607 Phone 800/959-2734 Fax www.breg.com info@breg.com Breg provides premium sports medicine products and services that advance orthopedic care. From cold therapy and bracing to practice solutions, Breg delivers a 360° customer experience.

Texas Assistive Devices LLC Brazoria, TX 800/532-6840 www.n-abler.org hps@n-abler.org Texas Assistive Devices (TAD) distributes UE prosthetic and orthotic components for individuals with hand dysfunction or amputation. TAD’s products include an interchangeable tool system featuring the N-Abler II to which a variety of adapted tools and utensils can be attached. The N-Abler II offers 360° radial deviation and 60° flexion on any plane, so that tools and implements can be held at a natural angle allowing the user to independently perform activities which might otherwise be impossible (eating, cooking, grooming, carpentry, fishing, etc.). TAD’s products coordinate with body-powered or myo-electric prostheses, as well as with wrist-hand-othoses (WHO) braces. All have L Codes.

Reference Materials and Business Services Otto Bock HealthCare Minneapolis, MN 800/328-4058 www.ottobockus.com • Cooperative Care is a consulting service that helps you with difficult or unusual high-tech fittings. An extension of our Professional and Clinical Services department, we work with you to speed up the fitting process and obtain excellent outcomes—while you retain your patient. Call Julie at 800/328-4058 x 5165 (Julie.Sohn@ottobock. com) for a free, no-obligation estimate.

• Reimbursement assistance from Otto Bock is just a phone call away. Talk to our expert staff about the

2011 2011 BUYERS’ BUYERS’ GUIDE GUIDE

SPECIALTY O&P DISTRIBUTORS

Medicare process, codes, and help with appeals. We’re here to help: Call 800/328-4058 and ask to speak with a reimbursement specialist.

2011 AOPA Coding Products Coding Suite New L codes? No problem! Order the 2011 AOPA Coding Suite today! Get your facility up to speed, fast, on all the O&P HCPCS code changes with an array of 2009 AOPA coding products. Get illustrations of each HCPCS code and the AOPA interpretations with the 2011 CodingPro software and 2011 Illustrated Guide. The CodingPro also contains Medicare fee schedules and medical policy information. Ensure each of your staff has a 2010 Quick Coder, a durable, easy-to-store desk reference of all the O&P HCPCS codes and descriptors. Now being offered at a lower price! (Coding Suite includes CodingPro single user, Illustrated Guide and Quick Coder): $350 AOPA members, $895 nonmembers.

• CodingPro CD-ROM (single-user version): $185 AOPA members, $425 nonmembers • CodingPro CD-ROM (network version): $435 AOPA members, $695 nonmembers • Illustrated Guide: $185 AOPA members, $425 nonmembers.

• Quick Coder: $30 AOPA members, $80 nonmembers.

Order at www.AOPAnet.org or by calling the AOPA bookstore at 571/431-0865.

$

AOPA PRODUCTS

Comprehensive Guide The Most Popular Orthotic and Prosthetic Illustrated Reference!

The De Prosth finitive Or tho etic Co ding tic and Resou rce

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A M E R I C A N O R T H O T I C & P R O S T H E T I C A S S O C I AT I O N ( A O PA )

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The O&P Almanac’s Buyers’ Guide is paid advertising. Entries were submitted and paid for by product manufacturers and distributors.

AOPA and the O&P Almanac do not endorse, support or recommend the use of any specific products included in the Buyers’ Guide. In addition, AOPA and the O&P Almanac neither sanction nor approve manufacturers’ claims about the function or reliability of their products.

These listings can also be found on AOPA’s website: www.AOPAnet.org.

When you contact manufacturers about these products, be sure to tell them you saw them in the O&P Almanac Buyers’ Guide.

JUNE 2011 O&P ALMANAC

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2011 BUYERS’ GUIDE

Comprehensive Index Companies in bold are AOPA members. are Supplier Plus Partners.

Companies with

+

$

Ability Dynamics LLC Scottsdale, AZ 480/717-1432 www.abilitydynamics.com clarkin@abilitydynamics.com ACOR Orthopaedic Inc. Cleveland, OH 216/662-4500 www.acor.com requestinfo@acor.com Acsys Orthopedic Vista, CA 760/598-8191 www.acsysortho.com sales@acsysortho.com Advanced O&P Solutions LLC Hickory Hills, IL 708/237-4088 www.aopsolutions.com mangelico@aopsolutions.com Aetrex Worldwide Inc. Teaneck, NJ 201/833-2700 www.aetrex.com info@aetrex.com Airway Cincinnati, OH 513/271-4594 www.airwaymast.com airway@saibrands.com

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O&P ALMANAC JUNE 2011

AliMed Inc. Dedham, MA 800/225-2610 www.alimed.com mdonovan@alimed.com

+Allard USA Inc. Rockaway, NJ 888/678-6548 www.allardusa.com info@allardusa.com

ALPS Saint Petersburg, FL 800/574-5426 www.easyliner.com info@easyliner.com Alternative Prosthetic Services Inc. Bridgeport, CT 203/367-1212 www.alternativeprosthetics.com info@alternativeprosthetics.com American Central Fabrication Shreveport, LA 318/636-3751 americancenfab@aol.com

+American

Prosthetic Components Inc. Green Bay, WI 800/772-7508 www.apcomponents.com comments@apcomponents.com

American Shoe Corp.

Brooklyn, NY 866/620-7463 www.americancustomshoes.com seagiz@aol.com Amfit Inc. Vancouver, WA 800/356-3668 www.amfit.com sales@amfit.com AMGF Inc. Global Prosthetic Development Nesconset, NY 631/979-4095 www.amgf-prosthetics.com info@amgf-prosthetics.com

ARTech Laboratory Inc. Midlothian, TX 972/775-2000 www.artechlab-prosthetics.com Mholt36107@aol.com Aspen Medical Products Irvine, CA 800/295-2776 www.aspenmp.com custserv@aspenmp.com Atlantic Rim Brace Manufacturing Corp.

Nashua, NH 800/233-0356 www.spinalbraces.com ebrace@spinalbraces.com

Anatomical Concepts Inc. Poland, OH 800/837-3888 www.prafo.com wadetoro@anatomical conceptsinc.com

ATLAS International Rancho Cordova, CA 916/858-3322 www.atlasortho.com atlas@atlasortho.com

Apis Footwear Co. El Monte, CA 626/448-8905 www.bignwideshoes.com apisfootwear@earthlink.net

Bader Prosthetics & Orthotics/Kinetic Research Inc. Tampa, FL 813/962-6100 www.readypreg.com BPO13711@aol.com

Arizona AFO Mesa, AZ 480/222-1580 www.arizonaafo.com don@arizonaafo.com

Becker Oregon Inc. Albany, OR 541/967-1821 www.beckeroregoncatalog.com cborn@beckerorthopedic.net Becker Orthopedic Appliance Co. Troy, MI 248/588-7480 www.beckerorthopedic.com mail@beckerorthopedic.net Bio-Mechanical Composites Inc. Des Moines, IA 515/720-6985 nchladek@aol.com Bio Prosthetic Orthotic Lab Inc. Ashburn, VA 703/726-4092 biolabva@aol.com www.biolabva.com BIONESS Inc. Valencia, CA 800/211-9136 www.bioness.com info@bioness.com BioQuest Prosthetics LLC Bakersfield, CA 661/325-3338 www.bioquestpros.com tramirez@bioquestpros.com BioSculptor Corp.

Hialeah, FL 305/556-5815 www.biosculptor.com bio_info@biosculptor.com BMI International Tampa, FL 877/603-3737 www.orthobmi.com sales@orthobmi.com

Bort-Swiss Orthopedic Supply Commerce, MI 248/242-6907 www.bort-swissortho.com beth.swiss@bort-swissortho.com Boston Brace International Inc. Avon, MA 508/588-6060 www.bostonbrace.com info@bostonbrace.com BREG Inc. Vista, CA 800/321-0607 www.breg.com info@breg.com Bremer Group Co. Jacksonville, FL 904/645-0004 www.bremergroup.com bremergroup@bremer.net Bulldog Tools Inc. Lewisburg, OH 937/962-4140 www.bulldogtools.com rmeyer@bulldogtools.com Cailor Fleming Insurance Youngstown, OH 330/782-8068 www.cailorfleming.com dfoley@cailorfleming.com Cascade DAFO Inc. Ferndale, WA 800/848-7332 www.cascadedafo.com dafo@dafo.com

+Cascade

Orthopedic Supply Inc. Chico, CA 530/879-1500 www.cascade-usa.com info@cascade-usa.com

+Center for

Orthotics Design–– A Fillauer Company Campbell, CA 800/346-4746 www.centerfororthotics design.com jcrowell@hosmer.com

Centri––A Fillauer Company Sollentuna, Sweden +46-8-505-332-00 www.centri.se bengt@centri.se

CIR Systems Havertown, PA 610/449-4879 www.gaitrite.com sales@gaitrite.com College Park Industries Inc. Fraser, MI 800/728-7950 www.college-park.com info@college-park.com Comfort Products Inc. Croydon, PA 800/822-7500 www.comfortoandp.com info@comfortoandp.com

CSUS LLC Rockaway, NJ 973/298-8599 diane.beesley@csusmed.com Cybertech Medical La Verne, CA 909/447-7050 www.cybertechmedical.com cs@cybertechmedical.com DAW Industries Inc. San Diego, CA 800/252-2828 www.daw-usa.com info@daw-usa.com Delcam Salt Lake City, UT 239/225-2837 www.delcam-healthcare.com marketing@delcam.com DeRoyal San Luis Obispo, CA 800/410-4422 www.deroyal.com mingersoll@deroyal.com

$

DeRoyal Industries Inc. Powell, TN 888/938-7828 www.deroyal.com tspann@deroyal.com

The Compliance Team Inc. Spring House, PA 215/654-9110 www.exemplaryprovider.com rjcanallyjr@tctinc.us

DJO Inc. Vista, CA 800/321-9549 www.djglobal.com dale.nammer@djglobal.com

Coyote Design Boise, ID 800/819-5980 www.coyotedesign.com mailbox@coyotedesign.com

Dr. Comfort Mequon, WI 262/242-5300 www.drcomfort.com rickk@drcomfortdpm.com

CrocsRx Niwot, CO 303/848-7399 www.crocsrx.com info@crocsrx.com

2011 2011 BUYERS’ BUYERS’ GUIDE GUIDE

Bauerfeind USA Inc. Kennesaw, GA 800/423-3405 www.bauerfeindusa.com info@bauerfeindusa.com

+ENDOLITE Miamisburg, OH 800/548-3534 www.endolite.com info@endolite.com

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2011 BUYERS’ GUIDE

Euro International Inc. Tampa, FL 813/246-5995 www.eurointl.com sales@eurointl.com

Forbin Waterloo, IA 866/999-9469 www.forbin.com jeremyk@forbin.com

Fabrica Machinale Navacchio Di Cascina, Italy +39-50-754290 www.fabricamachinale.it info@smrobotica.it

Forensic Prosthetic and Orthotic Consulting Suamico, WI 920/737-5462 blg.gustin@gmail.com

Fabtech Systems LLC Mukilteo, WA 425/349-9557 www.fabtechsystems.com staff@fabtechsystems.com

$

+Hosmer Dorrance

Corp.––A Fillauer Company Campbell, CA 800/827-0070 www.hosmer.com customerservice@hosmer.com

Freedom Innovations LLC Irvine, CA 888/818-6777 www.freedom-innovations.com info@freedom-innovations.com

Hutnick Rehab Support Services, Inc. Bohemia, NY 631/467-3725 Hutnickrehab@msn.com

+Fillauer Companies

Freeman Manufacturing Co. Sturgis, MI 269/651-2371 www.freemanmfg.com freeman@freemanmfg.com

Innovative Neurotronics Inc. Austin, TX 512/721-1900 www.ininc.com info@ininc.us

+Fillauer LLC––

Friddle’s Orthopedic Appliances Honea Path, SC 864/369-2328 www.friddles.com info@friddles.com

Joint Active Systems Effingham, IL 217/342-3412 www.jointactivesystems.com info@jointactivesystems.com

Ferrier Coupler Inc. North Branch, MI 810/688-4292 www.ferrier.coupler.com sales@coupler.com

Inc. Chattanooga, TN 423/624-0946 www.fillauercompanies.com fjenkins@fillauer.com

A Fillauer Company Chattanooga, TN 800/251-6398 www.fillauer.com customerservice@fillauer.com Florida Brace Corp.

Winter Park, FL 407/644-2650 www.flabrace.com customerservice@flabrace.com

+FLO-TECH Orthotic

Joli’s Orthopedic Futura International Inc. Shoes & Medical Supplies Anahiem, CA Weslaco, TX 727/791-3332 www.futuraintl.com 956/969-1323 ktripp@futuraintl.com joliesorthoshoes@aol.com Grace Prosthetic Fabrication Inc. New Port Richey, FL 800/940-5347 www.gpfinc.com grace@gpfinc.com

& Prosthetic Systems, Inc. Guard Industries Inc. Trumansburg, NY Saint Louis, MO 800/356-8324 800/535-3508 www.1800flo-tech.com www.guardmfg.com info@1800flo-tech.com guard@guardmfg.com

64

HOPE Orthopedic Orlando, FL 407/850-0411 www.hopeortho.com jim@hopeortho.com

O&P ALMANAC JUNE 2011

Kingsley Manufacturing Co. Costa Mesa, CA 949/645-4401 www.kingsleymfg.com info@kingsleymfg.com KISS Technologies LLC Baltimore, MD 410/663-5477 www.kiss-suspension.com

Knit-Rite Inc. Kansas City, KS 913/281-4600 www.knitrite.com customerservice@knitrite.com Lawson Medical LLC Virginia Beach, VA 866/631-6311 lawsonmedical@aol.com Levy & Rappel Saddle Brook, NJ 973/478-6511 www.LevyandRappel.com levyandrappel@optonline.net Liberating Technologies Inc. Holliston, MA 508/893-6363 www.liberatingtechnologies.com info@liberatingtech.com M. J. Markell Shoe Co. Inc. Yonkers, NY 914/963-2258 www.markellshoe.com markellshoe@optonline.com Maramed Orthopedic Systems Hialeah, FL 305/823-8300 www.maramed.com custsupport@maramed.com MD Orthopaedics Wayland, IA 877/766-7384 www.mdorthopaedics.com mdortho@farmtel.net The MED Group Lubbock, TX 800/825-5633 www.medgroup.com tpederson@medgroup.com Med Spec (ASO) Charlotte, NC 704/573-4040 www.medspec.com request@medspec.com

Medex International Inc. Burtonsville, MD 301/657-2681 info@medexinternational.com Medi USA Whitsett, NC 336/449-4440 www.mediusa.com salesandmarketing@ mediusa.com MICA Corp.

Kelso, WA 360/425-6661 www.micacorp.com info@micacorp.com Mike’s Medical Clinton, OK 888/419-5666 www.mikesmed.com teresa@mikesmed.com

+Motion Control––

A Fillauer Company Salt Lake City, UT 801/326-3434 www.utaharm.com info@utaharm.com Motion Medical Inc. Pelham, AL 205/982-1511 www.zcastusa.com sales@motionmedical.com

Nearly Me Technologies Inc. Waco, TX 254/662-1752 www.nearlyme.org kwilson@nearlymetech.com New Options Sports Dallas, TX 800/872-5488 www.newoptionssports.com info@newoptionssports.com

NOPCO Voorhees, NJ 856/258-6712 www.nopcoclinics.com info@bostonbrace.com

oandp.com Gainesville, FL 352/331-3741 www.oandp.com info@oandp.com

Orthomerica Products Inc. Orlando, FL 800/446-6770 www.orthomerica.com custserv@orthomerica.com

Nora Systems GmbH Shoe Components Weinheim, Germany +49-6201-80-7716 www.nora-shoe.com info-shoe@nora.com

OandPDirect.com Waterloo, IA 800/532-6729 www.oandpdirect.com

+Orthotic &

Northwood Inc. Center Line, MI 586/755-3830 www.northwoodinc.com debbiec@northwoodinc.com O&P 1 Central Fabrication Waterloo, IA 800/408-3598 www.oandp1.com info@oandp1.com O&P Billing Solutions Inc. Murfreesboro, TN 615/217-9821 www.oandpbilling.com wmiller@oandpbilling.com O&P Business News/ SLACK Inc. Thorofare, NJ 856/848-1000 oandpbiznews.com oandp@slackinc.com O&P EDGE/Western Media LLC Northglenn, CO 303/255-0843 www.oandp.com/edge tonja@opedge.com O&P Enterprises Inc. Gurnee, IL 800/666-0356 www.oandpenterprises.com opent@aol.com

OpalStar Strategies Shorline, WA 206/200-6705 www.opalstarstrategies.biz tami@opalstarstrategies.biz OPPO Medical Inc. Tukwila, WA 206/575-8843 www.oppomedical.com theresaw@oppomedicalusa.com OPTEC USA Inc. Lawrenceville, GA 888/982-8181 www.optecusa.com optecusa@aol.com Orfit Industries America Jericho, NY 516/935-8500 www.orfit.com sales-us@orfit.com Orten Lyon, France 011-33-472-611-727 www.orten.fr contact@orten.fr Orthocare Innovations Oklahoma City , OK 405/271-2466 www.orthocareinnovations.com mstanfield@orthocareinno vations.com Orthofeet Northvale, NJ 201/767-6224 www.orthofeet.com mb@orthofeet.com

Prosthetic Group of America (OPGA) Waterloo, IA 800/214-6742 www.opga.com jim.andreassen@vgm.com Össur Americas Inc. Foothill Ranch, CA 949/362-3883 www.ossur.com mail@ossur.com

+OTS Corp.––A

Fillauer Company Weaverville, NC 800/221-4769 www.ots-corp.com info@ots-corp.com

2011 2011 BUYERS’ BUYERS’ GUIDE GUIDE

Medequip Inc. San Juan Capistrano, CA 949/443-4414 soren@leadingmd.com

$

Otto Bock HealthCare Plymouth, MN 800/328-4058 www.ottobockus.com usa.custerservice@ ottobockus.com Peachtree Prosthetic & Orthotic Fabricators Monroe, GA 770/267-3711 www.peachtreefab.com jhughes@atlantapo.com PEL Supply Co. Cleveland, OH 216/267-5775 www.pelsupply.com customerservice@pelsupply.com PFS Med, Inc. Eugene, OR 541/349-9646 www.pfsmed.com rirish@pfsmed.com

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2011 BUYERS’ GUIDE

+Pilgrim Shoes

$

Baltimore, MD 410/277-8855 www.pilgrimshoes.com aaltskan@pilgrimshoes.com

PSL Fabrication Fulton, MO 573/642-5554 www.pslab.com pslab1@bcglobal.net

Pine Tree Orthopedic, Inc. Livermore Falls, ME 207/897-5558 www.pinetreeorthopedic.com mwells@pinetreeorthopedic.com

Quality Outcomes Fredericksburg, VA 540/412-1429 www.qualityoutcomes.org customerservice@qualityout comes.com

POINT Health Centers of America Waterloo, IA 866/283-2872 www.pointhca.com info@pointhca.com

Renia GmbH. Chemische Fabrik Koeln, Germany +011-49-221-630799-0 www.renia.com info@renia.com

+Professional

Technologies International Inc. Northborough, MA 866/819-1157 www.protech-intl.com mandersson@protech-intl.com Prosthetic Design Inc. Clayton, OH 800/459-0177 www.prostheticdesign.com bcarpenter@prosthetic design.com Prosthetic Orthotic Center of New England Portland, ME 207/838-4945 jbrow8@aol.com

Proteor Dijon Cedex. France +011-33-380-784-285 www.proteor.com ht.orthopedie@proteor.com Provel Inc. Cle Elum, WA 509/857-2059 www.provel.us info@provel.us

66

O&P ALMANAC JUNE 2011

Restorative Care of America Inc. St. Petersburg, FL 800/627-1595 www.rcai.com purch@rcai.com Roden Leather Co. Inc. Royal Oak, MI 800/521-4833 www.rodenleather.com info@rodenleather.com Royal Knit Inc. Lees Summit, MO 800/664-5648 www.royalknit.com royalknitinc@yahoo.com RX Textiles Inc. Monroe, NC 704/283-9787 www.rxtextiles.com info@rxtextiles.com Silipos Inc. Niagara Falls, NY 800/229-7105 www.silipos.com brij@silipos.com

SoleTech Inc. Salem, MA 877/625-9494 www.soletech.com jim@soletech.com

+Spinal Technology Inc. West Yarmouth, MA 800/253-7868 www.spinaltech.com info@spinaltech.com

SPS Alpharetta, GA 800/767-7776 www.spsco.com esales@spsco.com SPS National Labs Alpharetta, GA 800/767-7776 www.spsco.com esales@spsco.com ST&G USA Corp.

Placentia, CA 714/396-3739 www.stngco.com info@stngco.com SteeperUSA San Antonio, TX 210/481-4126 www.rslsteeper.com richard.shapcott@ rslsteeper.com

Syncor Ltd. Green Bay, WI 920/435-1199 syncorltd@netzero.com

+Tamarack

Habilitation Technologies Inc. Blaine, MN 763/795-0057 www.tamarackhti.com info@tamarackhti.com Texas Assistive Devices LLC Brazoria, TX 979/798-1185 www.n-abler.org hps@n-abler.org TiMED Inc. Torrance, CA 310/212-1232 www.ti-med.com info@ti-med.com Touch Bionics Middletown, NY 845/343-4668 www.touchbionics.com info@touchbionics.com Top Shelf Orthopedics Tracy, CA 209/834-1158 www.pacmedical.com csindel@pacmedical.com

Supan Prosthetic Orthotic Consultations Rochester, IL 217/741-3051 www.supanpoc.com tsupan@wildblue.com

+Townsend Design

SureFit Coral Springs, FL 800/298-6050 www.surefitlab.com jmeador@surefitlab.com

TRS Inc. (Therapeutic Recreation Systems Inc.) Boulder, CO 303/444-4720 www.oandp.com/trs bob-trs@att.net

SureStep South Bend, IN 877/462-0711 www.surestep.net bernie@surestep.net

Bakersfield, CA 661/837-1795 www.townsenddesign.com townsend@townsenddesign.com

+Trulife

Poulsbo, WA 888/878-1238 www.trulife.com info@trulife.com

VGM Financial Waterloo, IA 319/274-6661 www.vgmfs.com chamann@vgmfs.com

VGM Insurance Waterloo, IA 866/497-0836 www.vgminsurance.com service@oanpinsurance.com Vibrant Commercial Technologies Inc. Owing Mills, MD 800/439-3040 www.vibrantcommerce.com dandre.lewis@vibrant commerce.com

+WillowWood

Mount Sterling, OH 740/869-3377 www.owwco.com support@owwco.com Yale Surgical Company / Yale Comfort Shoe Center Bridgeport, CT 203/372-7112 www.yalesurgical.com ejkaufman@yalesurgical.com

2011 2011 BUYERS’ BUYERS’ GUIDE GUIDE

Truform Orthotics & Prosthetics Cincinnati, OH 513/271-4594 www.saibrands.com customerservice@ saibrands.com

Yale Surgical Company / Yale Comfort Shoe Center New Haven, CT 203/777-2396 www.yalesurgical.com ejkaufman@yalesurgical.com

$

Vorum Research Corp.

Vancouver, BC 800/461-4353 www.vorum.com canfit@vorum.com

JUNE 2011 O&P ALMANAC

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n

AOPA Applications

The officers and directors of the American Orthotic & Prosthetic Association (AOPA) are pleased to present these applicants for membership. Each company will become an official member of AOPA if, within 30 days of publication, no objections are made regarding the company’s ability to meet the qualifications and requirements of membership.

At the end of each new facility listing is the name of the certified or state-licensed practitioner who qualifies that patient-care facility for membership according to AOPA’s bylaws. Affiliate members do not require a certified or state-licensed practitioner to be eligible for membership.

At the end of each new supplier member listing is the supplier level associated with that company. Supplier levels are based on annual gross sales volume: Level 1: equal to or less than $1 million Level 2: $1 million to $1,999,999 Level 3: $2 million to $4,999,999 Level 4: more than $5 million

Arise Orthotics & Prosthetics Inc.

Bio-Tech Prosthetics & Orthotics of Durham Inc.

11855 Ullysses St. NE, Ste. 230 Blaine, MN 55434 763/755-9500 Fax: 763/755-9510 Category: Patient Care Facility Charles Kuffel, CPO, FAAOP

314 Crutchfield St. Durham, NC 27704 919/471-4994 Fax: 919/471-4995 Category: Patient Care Facility Michael Astilla, CO

Dynamic Prosthetic & Orthotic LLC

Nora Systems GmbH Shoe Components

2116 McCallie Ave. Chattanooga, TN 37404 423/622-2000 Category: Patient Care Facility Locke Davis, CPO

Hoehnerweg 2-4 Weinheim, Germany 69469 +49-6201-80-7716 Fax: +49-6201-88-4683 Category: Supplier Level One Peter Mueller

Fabrica Machinale Via Giuntini Navacchio Di Cascina, Italy 56023 +39-050-75-4290 Fax: +39-050-75-4233 Category: Supplier Level One Rossella Frassi

The MED Group 3223 S. Loop 287, Ste. 600 Lubbock, TX 79423 800/825-5633 Fax: 806/793-6480 Category: Supplier Level 1 Wayne Grau

Mercy Health System 2825 Prairie Ave. Beloit, WI 53511 608/365-2228 Category: Patient Care Facility M. Baston, CPO

PROWALK Orthotics & Prosthetics Inc. 7232 Van Nuys Blvd., Ste. 205 Van Nuys, CA 91405-2231 818/782-3435 Fax: 818/782-6858 Category: Patient Care Facility Yeaun Kang, CP

URMC Orthotics & Prosthetics 4901 Lac de Ville Blvd., Ste. 210 Rochester, NY 14618 585/341-9299 Fax: 585/340-1572 Category: Patient Care Facility Robert Brown, CPO a

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For advertising information, contact Dean Mather at 856/768-9360 or dmather@mrvica.com.

68

O&P ALMANAC JUNE 2011

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Advertisements and payments need to be received approximately one month prior to publication date in order to be printed in the magazine. Ads can be posted and updated at any point on the O&P Job Board online at jobs.AOPAnet.org.

No orders or cancellations are taken by phone.

Ads may be faxed to 571/431-0899 or emailed to srybicki@ AOPAnet.org., along with a VISA or MasterCard number, the name on the card and the expiration date. Typed advertisements and checks in U.S. currency made out to AOPA can be mailed to P.O. Box 34711, Alexandria, VA 22334-0711.

Note: AOPA reserves the right to edit Job listings for space and style considerations.

Responses to O&P box numbers are forwarded free of charge. Company logos are placed free of charge.

JOB BOARD RATES Visit the only online job Member Nonmember board in the industry at Rate Rate jobs.AOPAnet.org! $80 $140 Save 5 percent on O&P Almanac classified rates by placing your ad in both the O&P Almanac and on the O&P Job Board, online at jobs.AOPAnet.org.

70

O&P ALMANAC JUNE 2011

Inter-Mountain Certified Prosthetist, Certified Prosthetist/ Orthotist, Orthotic/Prosthetic Technician Nevada ABC accredited, privately owned O&P firm with three offices seeking experienced practitioner, skilled technician.

Competitive salary and benefits. Send resume to:

Tony Gorgun 2650 N. Tenaya Way, Suite 210 Las Vegas, NV 89128 Phone: 702/256-5265 Fax: 702/256-5205 Email: aponv@aol.com

Certified Prosthetist-Orthotist/ Certified Orthotist Idaho Immediate opening for an independent, self-motivated, organized ABC certified practitioner to join our team. We are a small family oriented company dedicated to providing excellent patient care in the heart of the Treasure Valley area of Boise, Idaho. We are seeking a 5+ year certified practitioner with excellent communication skills, highly motivated, and interested in seeing a wide variety of patients. We are looking for someone with the drive to help our company continue to grow while ensuring unsurpassed customer satisfaction. We offer a competitive salary and benefit package. Salary is commensurate with experience. Please forward your resume, in confidence, to:

Bill Karcher, CP Idaho Orthotic & Prosthetic Services 1859 S Topaz Way, Suite 100 Meridian, ID 83642 Phone: 208/884-1294 Fax: 208/884-1293 Email: Bill@idahooandp.com

Certified Othotist/Certified ProsthetistOrthotist/Board Eligible Montana Treasure State Orthotic and Prosthetic Clinic is an accredited well-established practice in Montana. We are looking for skilled and motivated practitioners to complement our growing independently owned O&P business. We offer a competitive salary, health-care benefits, 401(k) with profit sharing, and the opportunity for career advancement. All applications will be held in strict confidence.

Email: marc@tsopmt.com Fax: 406/585-1438

Mid-Atlantic Certified Prosthetist/Orthotist Philadelphia Culture, arts, history and architecture…not to mention cuisine! Philly has it all! It is the country’s fifth-largest city complete with art museums and galleries, serious shopping, all four major sports, and the University of Pennsylvania.

And, you can’t forget the Philly Cheese Steak! If you want more than a job and are ready to make a move, we would love to discuss your goals. We offer a very competitive salary and benefits package accompanied by relocation assistance and sign-on bonus potential…plus much more.

If interested, please contact, in confidence:

Sharon King Hanger Prosthetics & Orthotics, Inc. Phone: 512/777-3814 Fax: 512/777-3772 Sking@hanger.com www.hanger.com/careers

Certified Orthotist/Certified Fitter Long Island/New York City We are a well-established practice offering an excellent opportunity for a driven person with a positive attitude. We offer benefits including 401(k), health, and profit sharing.

Send resume to:

O&P Ad 0611, O&P Almanac 330 John Carlyle St., Ste 200 Alexandria, VA 22314 Fax: 571/431-8099

Northeast Orthotic Technician Mid-Hudson Valley, New York Established and independently owned O&P company has an immediate opening for a motivated and skilled technician.

Must be able to learn new fabrication techniques quickly and keep pace with a busy work load. Three or more years experience preferred. Great work environment, wages, and benefits, please fax resume to:

ATTN: Job Board Fax: 571/431-0899

JUNE 2011 O&P ALMANAC

71

ATTEND THE PREMIER O&P EVENT OF THE YEAR: THE 2011 AOPA NATIONAL ASSEMBLY We look forward to seeing you at the AOPA 2011 National Assembly September 19-22, 2011, at The Mirage Resort & Casino in Las Vegas!

THE MIRAGE—THE PLACE TO BE FOR THE PREMIER O&P EDUCATION EVENT OF THE YEAR! •

Exceptional $135 room rate at The Mirage Resort & Casino— AAA-Four Diamond Resort

•

Unprecedented business education featuring experts in health care reform, documentation, O&P business management, ethics, different business models, new round table discussions and more.

•

Experience the country’s largest and oldest trade show for the orthotics, prosthetics and pedorthics profession.

[ THE E C E PLTA OB

•

34 Continuing Education (CE) Credits applied for.

•

Scientific programs featuring an extensive symposium on treating spinal trauma with live demonstrations and futuristic topics such as osseo integration, robotics, stroke management, wound care and material science.

•

Fabulous shopping, entertainment, championship golf and unparalleled people watching—all of this right in the heart of the Las Vegas Strip!

SAVE THE DATE SEPTEMBER 19-22, 2011

]

Visit www.AOPAnet.org for updates on education and events.

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Jobs North Central Certified Prosthetist/Orthotist, Certified Orthotist, Board Certified Prosthetist

Come Join Our Team!

Shriners Hospitals for Children® is a one-of-akind international system of 22 hospitals dedicated to improving the lives of children by providing specialty pediatric care, innovative research, and outstanding teaching programs. Children up to age 18 with orthpaedic conditions, spinal cord injuries, and limb deficiencies are eligible for admission, care, and treatment regardless of financial need or relationship to a Shriner.

With recent program development and an expanding operative schedule we are anticipating a need to expand our O&P service to meet the need of our patients and hospital.

O&P Practitioner Works with a multi-disciplinary care team to determine, design, fabricate, fit, and evaluate the effectiveness of orthoses and prostheses for children with orthopedic impairments, spinal cord injuries, and limb deficiencies. Engages in evidence-based practice related to the field of orthotics, prosthetics, neuroprosthetics, and rehabilitation. Supports and actively engages in performance improvement initiatives and research.

Undergraduate degree in O&P, allied health field, engineering, kinesiology, biology, or biomechanics preferred. Experience in prosthetics and/or orthotics as evidenced by successful completion of an accredited prosthetic and/or orthotic program with certification by the American Board for Certification in Orthotics and Prosthetics. At least three years of experience preferred. Strong interest in working with children and families is a must.

Call, fax, or email inquires to:

Megan Hauser Shriners Hospitals for Children®-Philadelphia 3551 North Broad Street Philadelphia, PA 19140 Phone: 215/430-4061 Fax: 215/430-4180 Email: hr_phila@shrinenet.org

Privately owned practice with a 50-year track record has an immediate opening in our large, Midwest facility. We’re looking for an orthotist or prosthetist who is good with patients, familiar with the latest technology, aggressive with patient care, and motivated to help us market our facility.

We offer a competitive salary and health benefits. Send resume to:

Fax: 317/858-3146 Email: mhcbl@aol.com

Pacific Certified Orthotist Northern California Do you dream of earning six figures? Receiving a significant sign on bonus and working for the oldest and one of the most respected orthotic and prosthetic patient care companies in the world? Are you looking for security? In addition to the above, we offer competitive benefits, worldclass education fair, latest technology, and a family of over 1,000 practitioners in addition to the support of HR, sales/ marketing, accounting, etc. Our core values are: • Integrity • Clinical and operational excellence • Unsurpassed customer satisfaction • Flexible and entrepreneurial operations • Creativity and innovation • Shared success.

If you have the skills, drive and ambition … let’s talk!

Contact, in confidence:

Sharon King Hanger Prosthetics & Orthotics, Inc. Phone: 512/777-3814 Fax: 512/777-3772 Sking@hanger.com www.hanger.com/careers

JUNE 2011 O&P ALMANAC

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Classroom Education

MASTERING MEDICARE: Advanced Coding & Billing Techniques Seminar

Gas Las VE nIO nTO san a ORE BaLTIM

An intensive two-day workshop for O&P practitioners and office billing staff EaRn

14 dCITEs CREPER

AR

SEMIN

Master coding and billing for the most difficult devices without the panic that may have plagued you in the past! Led

by Joe McTernan, AOPA Medicare expert; Brian L. Gustin, CP; and Jonathan M. Naft, CPO, this seminar gives you the tips and hands-on experience you need to get paid for all of your O&P services.

Upon completion, you will receive 14 continuing education credits and a certificate to take back to the office to display your newly developed coding and billing skills. Attendees receive a free manual that contains comprehensive information on coding and billing. This will not only serve as a guide for the seminar, but is also an effective tool that can be utilized outside of the seminar.

Three locations to serve you in 2011––

May 19-20

The Mirage Resort, Las Vegas, NV

In the breakout session Practitioners will learn: • Coding principles • How to code complex devices • Coding of repairs and adjustments

JuNe 16-17

• Usage of ‘99 codes

San antonio Marriott Rivercenter, San antonio, TX

• Mutually exclusive codes In the breakout session administrators will learn: • How to comply with the Quality and Supplier Standards • Strategies for handling appeals and denials • How to handle unique billing situations • Documentation requirements • Billing for Medicare as secondary payer

OcT 24-25

everyone will cover:

Sheraton Inner Harbor, Baltimore, MD

• Medicare’s Medical Policies • Hints on better documentation • How to create a compliance plan • How to audit your charts

Don’t miss these upcoming opportunities! obtain more information and register online at www.aOPanet.org

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Jobs Certified Prosthetist-Orthotist

Pacific Certified Orthotist, Certified Prosthetist, or Certified Prosthetist-Orthotist Fresno and Monterey Bay Area, California Growing western states O&P business seeking certified CO, CP, or CPO for excellent opportunities in Fresno, California, and the Monterey Bay Area, California.

Unlimited business opportunities available in an expanding local market. Competitive salary, benefits, and profit sharing as the business grows.

Interested parties should email inquiries/resume to:

Fax: 888/853-0002 Email: jwiley@pacmedical.com

Southern California Do you want to work for an established, growing company in an environment that values clinical excellence and work/life balance? Do you want to live in one of the most desired and diverse areas in the country, beautiful Southern California? SCOPe has a career opportunity for you. We are a leading orthotics and prosthetics company looking for an energetic and motivated CPO to provide comprehensive assessment, treatment, and follow-up for our patients.

SCOPe offers competitive salaries as well as an excellent benefits package for full time employees. Salary is commensurate with experience.

Interested parties can send resumes via email to:

Fax: 858/292-5496 Email: jobs@scop.net www.scop.net All communications will be held in the strictest confidence.

AVAILABLE POSITIONS Orthotist

Why do I work for Hanger?

“

I like working for a company that cares for its employees as much as they care for their patients. That’s why I’ve been with Hanger for the past 28 years.

When Hurricane Katrina hit my hometown of New Orleans, Hanger was there for me. They gave me as much time as I needed—with pay—and helped me relocate to Atlanta.

By working at the largest prosthetic and orthotic company in the nation, I have more than just career opportunities.

I have an employer that treats me like family.

”

Tony Thaxton Jr., CPO, LPO, Certified Practitioner, Orthotist-Prosthetist

Folsom, CA Frisco, CO Pensacola, FL Griffin, GA Joliet, IL Belleville, IL Mt. Vernon, IL Urbana, IL

Evansville, IN Indianapolis, IN Michigan City, IN Paducah, KY Tahlequah, OK Alliance / Akron, OH Spartanburg / Union, SC

Prosthetist

American Canyon/Fairfield, CA Port St. Lucie/Melbourne, FL Hazel Crest, IL

Jackson, MS Albany, NY Enid, OK Austin, TX

Prosthetist/Orthotist Springdale, AR American Canyon/Fairfield, CA Long Beach, CA Denver, CO Thornton, CO Pensacola, FL Dubuque, IA Indianapolis, IN Michigan City, IN

Denver, CO Belleville, IL Tahlequah, OK

Bangor, ME Baltimore, MD Albany, NY Akron, OH Salem, OR Bend, OR Philadelphia, PA Memphis, TN Houston, TX

Certified Pedorthist

Olympia/Vancouver, WA Tacoma/Renton, WA

To apply for any of these positions, visit www.hanger.com/careers Orthotic Fitter Hanger Orthopedic Group, Inc. is committed to providing equal employment to all qualified individuals. All conditions of employment are administered without discrimination due to race, color, religion, national origin, sex, age, disability, veteran status, citizenship, or any

other basis prohibited by federal, state or local law. Residency Program or Certificate Primary Education Program Info, contact: Robert S. Lin, CPO/Dir. of Academic Programs. Hanger P&O/ Newington O&P Systems, Ph. 860.667.5304; Fax 860.667.1719

Riverdale , GA

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Calendar

2011 ■■ JUNE 8 AOPA Audio Conference: “Preventing Audit Disasters.”

To register, contact Ann Davis at 571/431-0876 or adavis@ AOPAnet.org.

■■

PROMOTE EVENTS IN THE O&P ALMANAC

CALENDAR RATES Telephone and fax numbers, email addresses, and websites are counted as single words. Refer to www.AOPAnet.org for content deadlines.

Member Nonmember Words Rate Rate 25 or less $40 $50 26-50 $50 $60 51+ $2.25 $3.00

per word per word Color Ad Special: 1/4 page Ad $482 1/2 page Ad $634

$678 $830

BONUS! Listings will be placed free of charge on the Attend O&P Events section of www.AOPAnet.org.

Send announcement and payment to: O&P Almanac, Calendar, P.O. Box 34711, Alexandria, VA 22334-0711, fax 571/431-0899, or email srybicki@AOPAnet.org along with VISA or MasterCard number, the name on the card, and expiration date. Make checks payable in U.S. currency to AOPA. Note: AOPA reserves the right to edit Calendar listings for space and style considerations.

For information on continuing education credits, contact the sponsor.

Questions?

Email srybicki@AOPAnet.org.

76

O&P ALMANAC JUNE 2011

■■ JUNE 8 Ultraflex: Pediatric UltraSafeGait™ Continuing Education Course, via WebEx, 5:00 – 6:00 pm ET. Covers assessment of pediatric pathological gait and influencing shank kinematics with the new Adjustable Dynamic Response™ (ADR™) technology. Presenter: Keith Smith, CO, LO. To register, call 800/220-6670 or visit www. ultraflexsystems.com.

■■ JUNE 8 Challenged Athletes Foundation: Heroes, Hearts and Hope Gala. New York City. Proceeds from the gala will be used to raise funds for and awareness of physically challenged athletes.

To learn more, visit www. challengedathletes.org or call 858/866-0959.

■■ JUNE 9-10 Michigan Orthotics & Prosthetics Association (MOPA) Continuing Education Meeting. Soaring Eagle Casino & Resort, Mt. Pleasant, MI. Contact Mary Ellen Kitzman, 248/615-0600, MOPA_meeting@mopa.info or visit www.mopa.info.

■■ JUNE 9 Hosmer Upper Extremity Seminar. Los Gatos, CA. Comprehensive seminar on upper-extremity prosthetics.

Areas the seminar will focus on are alternative upper extremity componentry, impression techniques, and harnessing. Learning objectives will include familiarization with work sources, biomechanics, componentry adjustment, and prosthetic optimization. To register, please contact Jackie Bradford at 800/827-0070 or jbradford@hosmer.com.

■■ JUNE 10 Advanced Lower Extremity Design Seminar. Los Gatos, CA. The seminar will examine the development of current composite dynamic foot and microprocessor knee systems with respect to biomechanics, physiologic function, and functional design classification.

Attendees will receive handson demonstrations that allow them to experience the new feet and knee designs first hand. Please contact Jackie Bradford at 800/827-0070 or jbradford@hosmer.com.

■■ JUNE 11 Ultraflex: Pediatric Spasticity Continuing Education Course, via WebEx, 9:00 – 10:00 am ET. Covers clinical assessment of the pediatric neuromuscular patient with spasticity and using R1 and R2 for determining orthotic design for maintaining and improving muscle length.

Presenter: Keith Smith, CO, LO, FAAOP. To register, call 800/220-6670 or visit www. ultraflexsystems.com.

■■ JUNE 13-17 Applied Technology Institute (ATi) Orthotic Fitter School, CSUDH Center for Orthotics and Prosthetics. Long Beach, CA. Independent comprehensive course to prepare for certification exam. Approved entry level school by NCOPE (ABC) and BOC; and for continuing education by ABC, BOC, and NATA. Contact Lois Meier at 888/265-6077 or lois@ kasseledu.com or visit www. kasseledu.com.

■■ JUNE 14 WillowWood: Discover LimbLogic® VS via WebEx, 10:30 am ET. Critical components and operation discussed. Covers interpreting feedback from fob and basic fabrication processes for system. Credits: 2.5 ABC/ 2.5 BOC. To register online, visit www.willowwoodco.com.

■■ JUNE 20-21 Allard USA: T.O.T.E. (Tomorrow’s Orthotic Technology Education).

Louisville, KY. Two courses: Concepts in Applied Biomechanics; Transferring CAB Principles into Customized Orthotic Solutions. 18 CEUs. Contact 888/678-6548 or email: info@ allardusa.com.

■■ JUNE 23-24 WillowWood: Existing OMEGA® Tracer® Users Orthotics and Prosthetics Course. Mt. Sterling, OH. Advanced course covers OMEGA Scanner use, modifying orthotic and prosthetic shapes, and review of custom liner, cranial, and spinal software.

Must be current OMEGA Tracer facility to attend.

Credits: 14.25 ABC/15.5 BOC. www.willowwoodco.com.

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Calendar

■■ JUNE 27-28 Allard USA: T.O.T.E. (Tomorrow’s Orthotic Technology Education).

Denver. Two courses: Concepts in Applied Biomechanics; Transferring CAB Principles into Customized Orthotic Solutions. 18 CEUs. Contact 888/678-6548 or email: info@allardusa.com.

■■ JUNE 28 Ultraflex: Adult UltraSafeStep™ Continuing Education Course, via WebEx, Noon – 1:00 pm ET. Focuses on normalizing adult pathological gait with the utilization of Adjustable Dynamic Response™ (ADR™) knee and ankle technology.

To register, call 800/220-6670 or visit www.ultraflexsystems. com.

■■ JUNE 30 Ultraflex: Complex Orthopedic Rehabilitation Continuing Education Course, via WebEx, Noon – 1:00 pm ET. Focuses on Ultraflex combination dynamic and static stretching orthosis for addressing complex orthopedic rehabilitation goals and restoring range and function.

To register, call 800/220-6670 or visit www.ultraflexsystems. com.

JULY 6 Ultraflex: Pediatric UltraSafeGait™ Continuing Education Course, via WebEx, 8:00 – 9:00 am ET. Covers assessment of pediatric pathological gait and influencing shank kinematics with the new Adjustable Dynamic Response™ (ADR™) technology. Presenter: Keith Smith, CO, LO, FAAOP. To register, call 800/220-6670 or visit www.ultraflexsystems.com.

■■

■■ JULY 13 AOPA Audio Conference: “Don’t Rile the OSHA Police.” To register, contact Ann Davis at 571/431-0876 or adavis@AOPAnet.org.

■■ JULY 18-19 Reciprocal Gait Orthosis Advanced Seminar.

Chattanooga, TN. Fillauer LLC and Center for Orthotics Design hosts a seminar on the Reciprocal Gait Orthosis.

Be part of the team that enables a spinal cord injury or congenital birth defect patient to leave their wheelchair and walk with a natural gait, regain independence, and make a difference in their lives. Contact Nicki Cantrell at 800/251-6398 or ncantrell@ fillauer.com.

■■ JULY 20 WillowWood: LimbLogic® VS for Technicians via WebEx, 1:30 pm ET. Learn essentials of elevated vacuum socket fabrication using available socket adaptors with LimbLogic VS. Learn how to deal with airtight issues, unit operation, and diagnostics that will keep the system optimal for patient use.

Credits: 2.5 ABC/2.5 BOC. www.willowwoodco.com.

■■ JULY 21-22 Allard USA: T.O.T.E. (Tomorrow’s Orthotic Technology Education).

Springfield, MA. Two courses: Concepts in Applied Biomechanics; Transferring CAB Principles into Customized Orthotic Solutions. 18 CEUs. Contact 888/678-6548 or email: info@ allardusa.com.

■■ JULY 28-29 Allard USA: T.O.T.E. (Tomorrow’s Orthotic Technology Education).

San Antonio. Two courses: Concepts in Applied Biomechanics; Transferring CAB Principles into Customized Orthotic Solutions. 18 CEUs. Contact 888/678-6548 or email: info@ allardusa.com.

■■ AUGUST 5-6 Texas Chapter of the American Academy of Orthotist and Prosthetist (TCAAOP) Annual Meeting and Scientific Symposium.

Sheraton Austin Hotel at the Capitol, Austin. For more information, go to www. txaaop.org or contact Suzanne O’Connor at 972/953-0860 or suzanne.oconnor@cpocare.com.

■■ JULY 28-29 WillowWood: Existing OMEGA® Tracer® Users Orthotics and Prosthetics Course. Mt. Sterling, OH. Advanced course covers OMEGA Scanner use, modifying orthotic and prosthetic shapes, and review of custom liner, cranial, and spinal software. Must be current OMEGA Tracer facility to attend. Credits: 14.25 ABC/15.5 BOC. www. willowwoodco.com.

■■ AUGUST 10 AOPA Audio Conference: “How to Get Paid for Miscellaneous and Repair Codes.” To register, contact Ann Davis at 571/431-0876 or adavis@AOPAnet.org.

2011 Advanced Lower Extremity Prosthetic Design Seminars JUNE 10

AUGUST 19

Los Gatos, CA

St. Louis, MO

JUNE 13

Santa Ana, CA

AUGUST 3

Baltimore, MD For more information regarding the seminars listed or to register, please contact Nicki Cantrell at 800-251-6398 or ncantrell@ fillauer.com

AD309 04-04-11

JUNE 2011 O&P ALMANAC

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Calendar

■■ AUGUST 11-12 Allard USA: T.O.T.E. (Tomorrow’s Orthotic Technology Education).

Ft. Lauderdale, FL. Two courses: Concepts in Applied Biomechanics; Transferring CAB Principles into Customized Orthotic Solutions. Approved for 18 CEUs. Contact 888/678-6548; email: info@allardusa.com.

■■ AUGUST 13 Arizona AFO Inc.: The Custom AFO Workshop.

Atlanta. Learn L-Coding, AFO selection, hands-on casting, footwear/modification tips and ideas for marketing to referral sources. The $150 fee includes lectures, handouts, and lunch. Approved for 6.5 ABC/7 BOC CEUs. To register, call 877/780-8382, ask for the “Workshop” or email education@arizonaafo.com.

■■ AUGUST 18 WillowWood: LimbLogic® VS Applications Practitioner Course. Mt. Sterling, OH. Course covers various clinical aspects of LimbLogic VS applications: static and dynamic socket fitting, vacuum pump configurations, fob operation, system evaluation, liner options, alignment, and troubleshooting. Credits: 7.25 ABC/7.75 BOC. Registration deadline: 7/28/11. Contact: 877/665-5443 or www. willowwoodco.com.

78

O&P ALMANAC JUNE 2011

■■ AUGUST 19 WillowWood: LimbLogic® VS Applications Technicians Course. Mt. Sterling, OH. Learn all aspects of fabricating LimbLogic VS for various applications: socket materials, controller configurations and care, fob operation, and troubleshooting.

Fabricate sockets following recommended techniques for airtight socket designs.

Credits: 9.75 ABC/9.75 BOC. Registration deadline: 7/28/11. Contact: 877/6655443. www.willowwoodco.com.

■■ AUGUST 25-26 Allard USA: T.O.T.E. (Tomorrow’s Orthotic Technology Education).

Madison, WI. Two courses: Concepts in Applied Biomechanics; Transferring CAB Principles into Customized Orthotic Solutions. Approved for 18 CEUs. Contact 888/678-6548; email: info@allardusa.com.

SEPTEMBER 14 AOPA Audio Conference: “Don’t Run Afoul of the KO Rules.” To register, contact Ann Davis at 571/431-0876 or adavis@AOPAnet.org.

■■

■■ SEPTEMBER 12-13 Allard USA: T.O.T.E. (Tomorrow’s Orthotic Technology Education).

Norfolk, VA. Two courses: Concepts in Applied Biomechanics; Transferring CAB Principles into Customized Orthotic Solutions. Approved for 18 CEUs. Contact 888/678-6548; email: info@allardusa.com.

■■ SEPTEMBER 19–22 AOPA National Assembly.

Las Vegas. Mirage Hotel. Exhibitors and sponsorship opportunities, contact Kelly O’Neill, 571/431-0852, or koneill@ AOPAnet.org.

■■ OCTOBER 12 AOPA Audio Conference: “Developing Your Medicare Billing Compliance Plan.” To register, contact Ann Davis at 571/431-0876 or adavis@ AOPAnet.org.

■■ OCTOBER 12-16 Skills for Life 3: Bilateral Upper Limb Loss Workshop, Denver Renaissance Hotel.

US Member Society-ISPO, Amputee Services of America and the Amputee Coalition.

For more information, visit www.usispo.org/skills_ for_life.asp.

■■ OCTOBER 15 Arizona AFO Inc.: The Custom AFO Workshop.

San Jose, CA. Learn L-Coding, AFO selection, hands-on casting, footwear/ modification and ideas for marketing to referral sources. The $150 fee includes lectures, handouts, and lunch.

Approved for 6.5 ABC/7 BOC CEUs. To register, call 877/780-8382, ask for the “Workshop” or email education@arizonaafo.com.

■■ NOVEMBER 9 AOPA Audio Conference: “Happy Holidays: Kickbacks and Gifts in O&P.” To register, contact Ann Davis at 571/4310876 or adavis@AOPAnet.org.

■■ NOVEMBER 19 Arizona AFO Inc.: The Custom AFO Workshop.

Phoenix. Learn L-Coding, AFO selection, handson casting, footwear/ modification tips, and ideas for marketing to referral sources. The $150 fee includes lectures, handouts, and lunch.

Approved for 6.5 ABC/7 BOC CEUs. To register, call 877/780-8382, ask for the “Workshop” or email education@arizonaafo.com.

■■ DECEMBER 14 AOPA Audio Conference: “Are You Ready for the New Year? 2012 New Codes and Policies.” To register, contact Ann Davis at 571/431-0876 or adavis@AOPAnet.org.

2012 ■■ MARCH 21–24 38th Academy Annual Meeting & Scientific Symposium. Atlanta. Hilton Atlanta. Contact Diane Ragusa at 202/380-3663, x 208 or dragusa@oandp.org.

2013 ■■ FEBRUARY 20–23 39th Academy Annual Meeting & Scientific Symposium. Orlando. Caribe Royale Orlando. Contact Diane Ragusa at 202/380-3663, x 208 or dragusa@oandp.org. a

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Ad Index

COMPANY

PAGE

PHONE

WEBSITE OR EMAIL

Allard USA Inc.

11

888/678-6548

www.allardusa.com

ALPS

31, 51

800/574-5426

www.easyliner.com

Orthotics, Prosthetics & Pedorthics

35

703/836-7114

www.abcop.org

Anatomical Concepts Inc.

37

800/837-3888

www.prafo.com

Apis Footwear

25, 41

888/937-2747

www.bigwideshoes.com

Becker Orthopedic

33

800/521-2192

www.beckerorthopedic.com

BOC International

45

877/776-2200

www.bocinternational.org

College Park Industries Inc.

23

800/728-7950

www.college-park.com

DAW Industries

1, 69

800/252-2828

www.daw-usa.com

Dr. Comfort

5, C3

800/556-5572

www.drcomfortdpm.com

Dycor

17

800/794-6099

www.dycormfg.com

Euro International

9

800/378-2480

www.eurointl.com

KISS Technologies LLC

15

410/663-5477

www.kiss-suspension.com

KNIT-RITE

2

800/821-3094

www.knitrite.com

M.J. Markell Shoe Co, Inc.

39

914/963-2258

www.markellshoe.com

Motion Control

13

888/696-2767

www.utaharm.com

O and P Study Guide

37

www.oandpstudyguide.com

OPTEC

18, 19

888/982-8181

www.optecusa.com

American Board for Certification in

Ossur® Americas Inc.

C4

800/233-6263

www.ossur.com

Otto Bock HealthCare

C2

800/328-4058

www.ottobockus.com

PEL Supply Company

27

800/321-1264

www.pelsupply.com

Spinal Technology Inc.

7, 57

800/253-7868

www.spinaltech.com

Willow Wood

insert

800/848-4930

www.owwco.com

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JUNE 2011 O&P ALMANAC

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AOPA Answers

Deliveries and Contracts Detailed answers to supplier-based questions

AOPA receives hundreds of queries from readers and members who have questions about some aspect of the O&P industry. Each month, we’ll share several of these questions and answers from AOPA’s expert staff with readers.

If you would like to submit a question to AOPA for possible inclusion in the department, email Editor Josephine Rossi at jrossi@strattonpublishing.com.

Q:

Who is responsible for payment of a custom device delivered to a patient in a Skilled Nursing Facility (SNF), when the item was ordered prior to the patient’s admission to the SNF?

A:

This will depend on where the patient was when the device was ordered. If the patient was residing at home when the device was ordered, you may bill Medicare directly, even if the item was a custom orthoses. Your delivery date will be your start date. But if the patient was in a hospital when the device was ordered, then you must seek payment from the hospital.

Keep in mind that this guideline only applies to custom orthotics and prosthetics; non-custom items and diabetic shoes will follow traditional billing guidelines.

Q: A:

How do I bill for an item I delivered to a patient in a hospice?

When beneficiaries elect hospice care, they have elected not to receive any care or treatment for their terminal illness. The hospice is only responsible, and being paid for, palliative care, or care designed to alleviate the symptoms, but not treat, the beneficiary’s terminal illness. So, if the device you are providing is not related to the beneficiary’s terminal illness, you may bill Medicare.

When you submit your claim, you must use the GW modifier. This will indicate that the item/service you provided is unrelated to the beneficiary’s terminal condition.

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O&P ALMANAC JUNE 2011

Q: A:

What constitutes a contract, according to Supplier Standard #4?

You don’t have to have a formal contract between your company and your suppliers in order to meet this standard. You must only have a document that contains, at a minimum, these components: • the signatures of both parties • an established credit limit • credit terms • both companies identified in the contract • dates contract is effective.

Keep in mind that Medicare doesn’t require you to have a minimum credit limit with your suppliers; you just must be able to demonstrate that you have the ability to purchase the items required to provide the item/services for which you are billing. a

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