OP
The American Orthotic & Prosthetic Association
FEBRUARY 2013
&
WWW.AOPAnet.ORG
THE MAGAZINE FOR THE ORTHOTICS & PROSTHETICS INDUSTRY
PATHWAYS TO
MOBILITY New advancements and early orthotic intervention for stroke patients can prevent and reduce long-term deformities
The ROI of CSR Preparing for a Medicare revalidation
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Price How important is
For over 50 years, PEL has offered O&P practitioners a fair and competitive price on the most popular and best performing products from leading manufacturers. In focusing on independents as our primary customer base, we are committed to outstanding and reliable service, day in and day out, to add consistent value wherever possible. Trulife Matrix Custom-Fit Carbon Composite AFOs
• Trimmable foot plate • Heat-moldable anterior shell • Four options to choose from (Matrix, Matrix Max, Matrix Split Toe, Matrix Max Split Toe) • Small to X-Large in Max models • Available in unique split toe version for low activity ambulators and Hallux amputations Matrix…..comprehensive solutions for your patients
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O&P FEBRUARY 2013, VOLUME 62, No. 2
CONTENTS Cover Story
18 Pathways to Mobility Cover photo: Sashkin/www.bigstock.com
By Jill Culora Early orthotic intervention for patients who have suffered strokes can prevent and reduce long-term deformities. Advances in technologies and materials have led to a spectrum of new orthoses that target foot drop, hip flexion, and upper-limb mobility.
Feature
24 The ROI of CSR Photo: U.S. Air Force photo by Staff Sgt. Nathan Allen
By Deborah Conn Operating in an ethical manner and minimizing your facility’s environmental impact are the basic tenets of corporate social responsibility. Going beyond those basics to make a difference in your community can lead to a spike in new business.
departments
4
AOPA Contact Page How to reach staff
6
At a Glance Statistics and O&P data
42 Jobs
In the News Research, updates, and company announcements
44 Calendar
AOPA Headlines News about AOPA initiatives, meetings, and more
47
Ad Index
48
AOPA Answers Expert answers to your FAQs
08 COLUMNS
14
Reimbursement Page Preparing for a Medicare revalidation
28
Facility Spotlight DuPage Prosthetic & Orthotic Services Inc.
30
39 AOPA Membership 00 Applications
40 Marketplace
Products and services for O&P Opportunities for O&P professionals
Upcoming meetings and events
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.
FEBRUARY 2013 O&P Almanac
3
AOPA IN THE Contact NEWS INFORMATION 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 & Meetings
BOARD oF DIRECTORS
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
Officers
directors
President Tom Kirk, PhD, Hanger Inc., Austin, TX
Jeff Collins, CPA, Cascade Orthopedic Supply Inc., Chico, CA
Don DeBolt, chief operating officer, 571/431-0814, ddebolt@AOPAnet.org
Kelly O’Neill, manager of membership and meetings, 571/431-0852, koneill@AOPAnet.org
Scott Schneider, Ottobock, Minneapolis, MN
O&p Almanac
Stephen Custer, coordinator, membership operations and meetings, 571/431-0876, scuster@AOPAnet.org
President-Elect Anita Liberman-Lampear, MA, University of Michigan Orthotics and Prosthetics Center, Ann Arbor, MI
Thomas F. Fise, JD, publisher, 571/431-0802, tfise@AOPAnet.org Josephine Rossi, editor, 703/914-9200 x26, jrossi@strattonpublishing.com Catherine Marinoff, art director, 786/293-1577, catherine@marinoffdesign.com Dean Mather, advertising sales representative, 856/768-9360, dmather@mrvica.com Stephen Custer, production manager, 571/431-0876, scuster@AOPAnet.org Lia K. Dangelico, contributing writer, 703/914-9200 x24, ldangelico@strattonpublishing.com Christine Umbrell, editorial/production associate, 703/914-9200 x33, cumbrell@strattonpublishing.com
Lauren Anderson, coordinator, membership operations and meetings, 571/431-0843, landerson@AOPAnet.org AOPA Bookstore: 571/431-0865 Communications Steffanie Housman, content strategist, 571/431-0835, shousman@AOPAnet.org Government affairs Catherine Graf, JD, director of regulatory affairs, 571/431-0807, cgraf@AOPAnet.org
Vice President Charles H. Dankmeyer, Jr., CPO, Dankmeyer Inc., Linthicum Heights, MD Immediate Past President Thomas V. DiBello, CO, FAAOP, Dynamic O&P, a subsidiary of Hanger Inc., Houston, TX Treasurer James Weber, MBA, Prosthetic & Orthotic Care Inc., St. Louis, MO Executive Director/Secretary Thomas F. Fise, JD, AOPA, Alexandria, VA
Reimbursement/Coding: 571/431-0833, www.LCodeSearch.com
Dave McGill, Ă–ssur Americas, Foothill Ranch, CA Ronald Manganiello, New England Orthotics & Prosthetics Systems LLC, Branford, CT Eileen Levis, Orthologix, LLC, Trevose, PA Michael Oros, CPO, Scheck and Siress O&P Inc., Oakbrook Terrace, IL Kel Bergmann, CPO, SCOPe Orthotics & Prosthetics Inc., San Diego, CA Alfred E. Kritter, Jr., CPO, FAAOP, Hanger, Inc., Savannah, GA
Devon Bernard, manager of reimbursement services, 571/431-0854, dbernard@AOPAnet.org Joe McTernan, director of coding and reimbursement services, education and programming, 571/431-0811, jmcternan@AOPAnet.org
Mike Hamontree, Hamontree Associates, Newport Beach, CA
James Campbell, PhD, CO, Becker Orthopedic Appliance Co., Troy, MI
O&P Almanac Publisher Thomas F. Fise, JD Editorial Management Stratton Publishing & Marketing Inc. Advertising Sales M.J. Mrvica Associates Inc. Design & Production Marinoff Design LLC Printing Dartmouth Printing Company
Copyright 2013 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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O&P Almanac FEBRUARY 2013
Discover a New World of Motion. Free Motion with Less Pain!
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AT IN THE A GLANCE NEWS
O&P and Stroke Patients Orthotists and prosthetists must use special care when it comes to stroke patients, as the population is likely to be older and require assistance with ambulation post-stroke.
15%
Prevalence of stroke by age and gender: n Men
13.9%
13.8%
n Women
12% 9% 6.2%
6% 3% 0%
2.1% .4%
6.9%
2.1%
.4%
Age 20-39
Age 40-59
Age 60-79
Age 80+
Source: “Heart Disease and Stroke Statistics—2013 Update,” Circulation, published by the American Heart Association.
Every 40 seconds Frequency with which someone in the United States has a stroke.
6.8 million
Number of stroke survivors in the United States over age 20.
80%
Percentage of stroke survivors affected by hemiparesis, causing weakness or the inability to move one side of the body.
1/3
Fraction of stroke patients who have permanent, significant dysfunction in their upper limbs.
35%
Percentage decrease in annual stroke death rate between 1998 and 2008.
$73.7 billion
Estimated direct and indirect cost of stroke in the United States in 2010.
Sources: National Stroke Association; Centers for Disease Control and Prevention; “Heart Disease and Stroke Statistics—2013 Update,” Circulation, published by the American Heart Association; “Stroke: Managing Patient Recovery,” published by NursingCEU.com; www.stroke.org. 6
O&P Almanac FEBRUARY 2013
THE MOST CLINICALLY PROVEN OA BRACE WITH A NEW TWIST. The Unloader line of braces by Össur are clinically proven to reduce pain and improve function for patients who wear them. Recent clinical research* demonstrates that the Unloader One® provides decreased pain, improved function and reduction in pain medications for patients. * Briggs KK, Matheny LM, Steadman JR. Improvement in quality of life with use of an Unloader knee brace in active patients with OA: A prospective cohort study. J Knee Surg 2012; Advance online publication. Retrieved 23rd August 2012. DOI:10.1055/S-0032-1313748
SmartDosing™ now available. SmartDosing, powered by Boa® Technology, provides patients with a simplif ied, single-hand dosing dial for on-the-f ly adjustability of the dual Dynamic Force Straps (DFS), helping them better manage their unicompartmental OA knee pain.
Lightweight, low-profile and easy. Unloader One‘s lightweight, low-profile design is barely noticeable to the user and fits comfortably under clothing. And, by utilizing the new SmartDosing dial, users can easily adjust the dual DFS tension right through their clothes.
Prescribe the Unloader One for any OA patient. If they are not happy with it for whatever reason, they can return it within 30 days for a full refund.
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IN THE NEWS
Prosthetic Advances Rank 4th on Science News’ Top Stories of 2012 The increasing reality of bionic technologies took fourth place in Science News’ list of the top 25 stories in 2012. The magazine cited neurological control of prostheses, batterypowered robotic suits, and the use of carbon blades and microprocessor-controlled legs by Paralympic and Olympic athletes, as well as research that showed paralyzed rats could regain movement with the help of drugs and electric shocks. “This was a big year for prosthetic parts, both in and out of the lab,” noted Science News’ Rachel Ehrenberg. The article cited the BrainGate2 study, in which two tetraplegic individuals unable to speak due to brainstem strokes used brain activity to control two different robotic arms. (For details on that study, see the June 2012 issue of the O&P Almanac; visit www.bluetoad.com/ publication/?i=114534.)
ABC Releases Assistant and Therapeutic Shoe Fitter Practice Analyses The American Board for Certification in Orthotics, Prosthetics & Pedorthics Inc. (ABC) has released the first practice analyses of both the ABC-certified assistant and therapeutic shoe fitter credentials. ABC’s Practice Analysis Task Force and ABC Executive Director Catherine Carter worked with Professional Examination Services to create and implement practice analyses of these professions. The strategy for both surveys included a validation study to determine current trends in patient care, technology, and practice management in both the orthotic and prosthetic assistant profession and the provision of therapeutic shoes by ABC-certified individuals. ABC will use the results of the practice analysis surveys to ensure that its assistant and therapeutic shoe fitter credentialing exams are continually relevant for individuals entering these professions. The results also will be used to identify specific topics for in-service and continuing education programs, as well as provide guidance for education providers in regard to curriculum review and program self-assessment. Visit www.abcop.org to download copies of Practice Analysis of ABC-Certified Assistants in the Disciplines of Orthotics and Prosthetics and Practice Analysis of ABC-Certified Therapeutic Shoe Fitters.
8
O&P Almanac FEBRUARY 2013
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IN THE NEWS
CMS Increases DMEPOS 2013 Fee Schedule The Centers for Medicare & Medicaid Services (CMS) has announced a 0.8 percent fee schedule increase for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS), effective for claims with a date of service on or after Jan. 1, 2013. Further, 2013 fees for several Healthcare Common Procedure Coding System (HCPCS) labor payment codes have been increased by 1.7 percent, effective for dates of service on or after Jan. 1, 2013, through Dec. 31, 2013. Affected L codes specific to O&P are L4205 (repair of orthotic device, labor component, per 15 minutes) and L7520 (repair of prosthetic device, labor component, per 15 minutes). The fee schedule amount for the one new O&P-specific L code, L5859 (addition to lower-extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)), effective Jan. 1, 2013, will be established as part of the July 2013 DMEPOS Fee Schedule Update, when applicable. Also when applicable, Durable Medical Equipment Medicare Administrative Contractors will establish the local fee schedule amount to pay claims for the new code from Jan. 1, 2013, through June 30, 2013.
TRANSITIONS
people in the news
Kendra Calhoun, the Amputee Coalition’s president and CEO, has been selected to serve on the National Health Council (NHC) Membership Committee. The NHC is a nonprofit association of health organizations working to strengthen the work of patient advocacy organizations, increase public awareness and advocacy programs, and support health research. Separately, Calhoun was elected chair of the AOPA Center for Orthotic & Prosthetic Learning/ Evidenced-Based Outcomes. With more than 20 years of health-care nonprofit leadership, she has significantly expanded the Amputee Coalition’s brand awareness, philanthropy, and influence throughout the United States. Malisse Haarl has been named national sales director for OPTEC USA in Atlanta.
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O&P Almanac FEBRUARY 2013
For gap-filling purposes, the 2012 deflation factor for prosthetics and orthotics is 0.482. The fee schedule amounts for certain shoe modification codes are being revised, effective Jan. 1, 2013, to reflect more current allowed service data. The affected codes and their short descriptions are listed below: • A5503 - diabetic shoe with roller/rocker • A5504 - diabetic shoe with wedge • A5505 - diabetic shoe with metatarsal bar • A5506 - diabetic shoe with offset heel • A5507 - modification diabetic shoe.
Eric Ronning, a junior in the University of Wisconsin-Madison mechanical engineering department, earned second place in the undergraduate division of the 2012 National Collegiate Inventors Competition. Ronning created an inexpensive, body-powered prosthetic hand that visually replicates an amputee’s lost hand. Ronning used magnetic resonance imaging of an amputee’s existing hand coupled with high-end three-dimensional printing technology to create and print a lifelike prosthesis, which includes fully hinged fingers. David R. Sickles, CPO, C.Ped, has been named managing partner of the Center for Orthotic & Prosthetic Care (COPC) of North Carolina.
In Memoriam Robert C. Gruman, CP(E), a past president of AOPA (1964), died Dec. 14, 2012, at the age of 90. He worked at The Winkley Company in Minneapolis from 1938 to 1984. Gruman was the third generation of family ownership of Winkley. In addition to his work at Winkley, Gruman served in World War II as a weather observer in Cairo and Benghazi, Egypt, from 1943 to 1946. He helped start the O&P program at Century College in White Bear Lake in 1974 by securing startup funding and hiring the first director. After his retirement, he was succeeded at Winkley by his son, Greg Gruman, CP.
IN THE NEWS
ISOCENTRIC® RGO
Isocentric reciprocating gait orthoses (IRGOs) and powered gait orthoses (PGOs) offer some benefits over conventional HKAFOs, according to “The Physiological Cost Index of Walking With Mechanical and Powered Gait Orthosis in Patients With Spinal Cord Injury.” The article, published in December in Spinal Cord, explains how researchers from the O&P department at the University of Social Welfare and Rehabilitation Science, Tehran, Iran, compared the energy expenditures of five people with spinal cord injuries using an HKAFO, an IRGO, and a PGO. The participants, who were experienced HKAFO users, were asked to walk along a flat walkway using each type of orthosis at their self-selected walking speed. Researchers used a stopwatch and a heart-rate monitor to measure the walking speed and heart rate of each patient with each device. According to the researchers, the data established that the distance walked and the physiological cost index improved with both the PGO and the IRGO when compared to the HKAFO.
2 0 1 3 A O PA P O L I C Y F O R U M 2013 TENTATIVE* SCHEDULE:
3/12 TUESDAY 11:00 a.m. – 3:00 p.m. Registration Open 11:00 a.m. – 1:00 p.m. AOPA State Representatives Meeting
MARCH 12-13
2013
L’ENFANT PLAZA HOTEL
WASHINGTON, DC
Concerned about excessive, unfair CMS RAC and Pre-Payment Audits? Worried About Potential O&P Fee Schedule Reductions from Sequestration or Threats to Harm Your Patients Through Expanded O&P Competitive Bidding?
You Can Make a Difference Plan to Attend AOPA’s 2013 Policy Forum March 12-13, 2013 AND BRING A PATIENT WITH YOU!
1:00 p.m. – 5:00 p.m. Policy Forum General Sessions 6:30 p.m. Attendee Reception & Dinner
3/13 WEDNESDAY 7:30 a.m. Attendee Breakfast and General Session 8:30 a.m. – 5:00 p.m. Congressional Appointments *This is a tentative schedule. Times and events may change.
www.AOPAnet.org FEBRUARY 2013 O&P Almanac
11
Photos: www.fillauar.com
Powered Gait Orthoses Decrease SCI Energy Expenditures
IN THE NEWS SIMULATION STUDY RESULTS
Dorsiflex Key to Improved Toe Clearance A team of researchers studied foot clearance using various transfemoral prostheses and published the results in “Contribution of Prosthetic Knee and Ankle Mechanisms to Swing-Phase Foot Clearance,” in Neural Systems and Rehabilitation Engineering, an IEEE publication. The research team analyzed toe clearance during prosthetic swing phase as a contributing factor in the likelihood of falls for prosthesis users. The researchers concluded that four-bar knees provide greater foot clearance than single-axis knees during prosthetic swing phase, but prosthetic ankle mechanisms that dorsiflex during swing phase provide substantially more. For data collection, researchers fitted transfemoral amputees with either single-axis or four-bar knees, and measured toe clearance during prosthetic swing phase from each trial. Two currently available prosthetic ankle
TRANSITIONS
Cascade Orthopedic Supply, Chico, California, announced the opening of a new 24,000-square-foot distribution center in Chicago. Hanger, Austin, has announced the acquisition of two patient-care companies: Faith Prosthetic-Orthotic Services, headquartered in Concord, North Carolina, and SCOPe Orthotics & Prosthetics, headquartered in San Diego. OPAF, the Orthotic & Prosthetic Activities Foundation, has relocated its headquarters to Charlotte, North Carolina.
O&P Almanac FEBRUARY 2013
8 5.8 cm
6.4 cm
6
4.6 cm
4 2
Single Axis Knees
Four-Bar Knees
Two Ankle Mechanisms
0
mechanisms with dorsiflexion were modeled, and threedimensional swing-leg simulations were used to differentiate between toe clearance attributed to knee mechanisms and those produced by compensatory gait differences. The data demonstrated that four-bar mechanisms had an empirical average of 2.2 cm more minimum toe clearance than single-axis knee mechanisms. In the simulation study, single-axis knees provided the least clearance (4.6 cm), followed by four-bar knees (5.8 cm) and the two ankle mechanisms (6.4 cm and 8.7 cm). a
BUSINESSES in the news
The American Board for Certification in Orthotics, Prosthetics, & Pedorthics Inc. is seeking nominations for two positions on its board of directors. The deadline for submission of nominations is June 1, 2013. Contact Steve Fletcher, CPO, LPO, sfletcher@ abcop.org or 703/836-7114.
12
10
8.7 cm
Ottobock has created an Upper-Limb Prosthetics Team, which will work closely with the company’s customers while using team members’ strengths to address complexities of the upper-limb business. The team, led by Dave Slipher, business development manager and sales specialist, also comprises Gerald Stark, CPO/L, FAAOP; Julie Schick, CP; Tim Shride, CPO; Scott Weber; and Will Perry.
A research team from the University of California, Los Angeles (UCLA), has created software that allows patients with diabetes and other chronic foot ailments to track and monitor their skin conditions at home using a computer and flatbed scanner. The software package, called BigFoot, can be downloaded free of charge and used by consumers and medical professionals in clinical settings.
Organizers of the ORTHOPÄDIE + REHA-TECHNIK (O+R) International Trade Show and World Congress have announced that it will now be known as OTWorld. The event will continue to combine the product areas of compression therapy, orthotics, prosthetics, orthopedic footwear technology, podiatry, and rehabilitation technology.
The Veterans Affairs Palo Alto Health Care System’s (VAPAHCS), California, Prosthetic and Sensory Aids Service (PSAS) was awarded the Veterans Health Administration’s Prosthetic and Sensory Aids Service of the Year Award, given each year to one of 153 prosthetic and sensory aids services in the VA. The team was judged in an array of criteria, including innovative processes, outstanding customer service, nationally recognized survey results, and compliance with performance measurements.
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Extreme Contact-- 80% Less Vertical Stretch 80% Less Vertical Stretch As compared to other Alps Posteriorly gel liners, resulting in As compared to other Alps gel demonstratively increased liners, virtually eliminating contact while stabilizing pistoning minimizing movementwhile of redundant tissue. bunching behind the knee during flexion
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Reimbursement Page By Devon Bernard, AOPA government affairs department
Preparing for a Medicare Revalidation Tips to make the process as painless as possible
M
edicare is in the process of revalidating all suppliers who enrolled in the Medicare program prior to March 25, 2011, as mandated in the Affordable Care Act. The revalidation process should be completed by March 25, 2015, and after completion, the normal schedule of re-enrolling with the Medicare program every three years should resume. The reason the revalidation process is targeting everyone who enrolled prior to March 25, 2011, is because those suppliers were not subject to the revised Medicare enrollment standards. As you know, about two years ago Medicare revised its enrollment process for obtaining a supplier number and enrolling in the Medicare program. Those revisions include the following four key components: 1. Medicare has the ability to enforce an enrollment moratorium or put a hold on any future supplier enrollments. The enrollment moratoria would be in six-month increments and could be geographical in nature or by provider type. A moratorium would only be imposed if CMS identifies trends of fraud, waste, or abuse. Those moratoria would only apply to newly enrolling
14
O&P Almanac FEBRUARY 2013
providers or those enrolling new locations. 2. CMS can invoke payment suspensions, typically lasting for 18 months, based upon a “credible allegation� of fraud. An allegation of fraud may come from any source, including but not limited to the following: fraud hotline complaints; claims data mining; and patterns identified through provider audits, civil false claims cases, and law enforcement investigations. It is important to note that CMS does recognize there is a difference between fraud and billing errors that result simply in an overpayment. Thus, CMS will carefully review allegations before enacting payment suspensions. 3. CMS will have an enrollment fee. CMS will now charge a fee to enroll in the Medicare program. When you fill out an enrollment form, either the paper 855S version or the online PECOS version, for a new enrollment or a revalidation of your existing supplier number, you will have to include a fee to cover the processing of your application. The fee for 2013 is $532, but it does not apply if you are just making changes or updating information about a current location.
Anyone can wear a white coat. But not everyone is ABC certified in Orthotics and Prosthetics. Do your homework.
ABC. Simply the best.
American Board for Certification in Orthotics, Prosthetics & Pedorthics, Inc.
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SCAN THE CODE to learn more about O&P resources
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Reimbursement Page
4. CMS now has three screening categories or risk groups: limited, moderate, and high. Each group must meet certain criteria in order to obtain or keep its supplier number, and the criteria—described below— are what will be the focus of the revalidation process. For the limited risk category, CMS will verify any provider/ supplier specific requirements established by Medicare (e.g., conduct license verifications and database checks). Those checks will include verifying Social Security numbers, reviewing the National Provider Identification (NPI), looking for Office of Inspector General (OIG) exclusions, and confirming tax ID numbers. For the moderate risk category, this group will have to meet all of the enrollment requirements for the limited risk group, plus it will have unscheduled/unannounced site visits. Finally, for high risk providers to enroll in Medicare or be revalidated, they must meet the requirements for limited and moderate risk providers, but they also will have to undergo background checks and fingerprinting. The fingerprinting for high-risk providers will only be required for those people who own 5 percent or more of the business. However, at this time the fingerprinting and background checks have not been implemented.
Effect on O&P Unfortunately, O&P providers will never be considered limited risk. If you are re-enrolling or revalidating your current location, you will be considered moderate risk. If you are opening and enrolling a new facility, even if it is just a satellite facility and you have other facilities enrolled with Medicare, you will be considered high risk. So, how will you know when it is time to revalidate? What can you expect during the revalidation process? What can you do to get ready for your revalidation and ensure that the revalidation process goes smoothly? What
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CMS Screening Categories
> HIGH > MODERATE > LIMITED
happens if you don’t revalidate your Medicare enrollment? Here’s the first thing you will want to do: Verify your information. This is critical because incorrect information may delay your revalidation or cause confusion and headaches during the revalidation process. You will want to review the data currently on file with Medicare by examining a copy of your most recent enrollment application. Is the information on the application still correct? For example, does the application reflect your current address? If the addresses don’t match, be sure to update the information immediately. You also will want to make sure that the information you have on file for your NPI number is up-to-date, and matches the information on your most current Medicare enrollment application. For example, is the name of the business the same? To check or update your NPI information, visit the National Plan and Provider Enumeration System website: www.nppes.cms.hhs.gov. Ultimately, you will want to make sure all the information regarding your tax ID number is current and accurate. You cannot revalidate on your own; you must wait until you are contacted by CMS, who will send you a letter with directions on how to revalidate. In essence, you will complete a new enrollment application. This is the reason you want to make sure all the above information is current, accurate, and matching because CMS will use that information to determine where to
send your revalidation request. Once you receive the revalidation letter, you have 60 days from the date of the letter (not from the date you received the letter) to respond. If you don’t respond to the request, your Medicare supplier number can be deactivated, which means you will lose the ability to see and bill Medicare patients. CMS has created a database you can use to search and find out if your facility has been sent a revalidation letter. Access that database by visiting the CMS website at www.cms.gov/ Medicare/Provider-Enrollment-andCertification/MedicareProviderSupEnroll/ Revalidations.html. If you check the database and notice you have been sent a revalidation letter, but you have not received it yet or you notice it was sent to the wrong location, notify CMS and the National Supplier Clearinghouse (NSC), Palmetto GBA immediately. You will want to request a new letter and the one-time 60-day extension, which is active from the date you make the request. Because the turnaround time between receiving the revalidation letter and revalidating is relatively short, you may want to consider registering with Internet-based Provider Enrollment, Chain, and Ownership System (PECOS), if you have not already done so. The PECOS system has several advantages over the traditional paper Medicare enrollment form or the 855S form. For example, the processing time is faster, approximately 45 days compared to 60 days. PECOS allows you to make corrections quicker as well, and, most important, it eliminates the guesswork. PECOS automatically tailors the form to your needs, so you only have to fill out the information that is pertinent to you, which saves you time. To sign up or register to use the PECOS system, visit this website: https://pecos.cms.hhs.gov/pecos/login.do. The next thing you can do to prepare for your revalidation is to make sure all
n
of your current supporting documents are in order. These documents do not include your tax ID and NPI information. Supporting documents consist of your federal and state licenses, certifications, and insurance documents (liability, surety bond, etc.). So, take time to ensure all of your insurance is up-to-date and for the proper amounts; also, review all of your certifications and accreditation, if required, and make sure they are still active. If you are in a licensure state, you also will want to verify that all of your state licensure information is current. If you are unsure what type of licensure your state requires or want to verify that your information is accurate, visit the NSC website and check out its licensure database at www.palmettogba.com. The database shows the information the inspector will be using during his or her visit. If the database incorrectly lists that you require a specific license, you will want to get the site updated before your visit—or determine if something has changed, and you now require a license. Lastly, make sure all of this documentation is in one place and organized, so you can find it with ease and provide exactly what the inspector requests. Next, perform a double check of the OIG exclusion list by going to www. oig.hhs.gov/fraud/exclusions.asp to verify that none of your employees, vendors, owners, etc., is on the exclusion list. Finally, as unannounced site visits are a part of the revised enrollment process, you will want to always be prepared for one. Here are some tips to get you ready: • Be sure everyone on staff knows what to do when the inspector comes. Can anyone deal with the inspector, or do you have one main contact person? Does everyone on staff know who the main contact person is and how to get in touch with that person? If anyone can deal with the inspector, does all of the staff know where the pertinent documentation (e.g., all licenses) is located?
• Ensure that all of your company’s policy and procedure manuals are up-to-date and are being followed. You may want to take a moment to review the company’s policies and procedures with your employees. • Review the 30 supplier standards and know which ones apply to you—and how they apply to you—because those standards are going to be the main focus of the site visits. For example, for Supplier Standard 4, do you have to have a minimum amount of credit with your contract, and what constitutes a contract? Answer: There is not a minimum amount of credit you must have established with your contracts. Here are the guidelines for what is considered an acceptable contract or purchasing agreement: an established credit limit, credit terms, both companies identified in the terms, and the length of the contract or agreement.
Reimbursement Page
It is important to note that if your revalidation or enrollment application is denied because you do not meet all of the supplier standards, CMS will not refund your application fee. To view the complete 30 standards and how the NSC and the inspector interprets them, or to answer any questions you may have about the standards, visit the NSC website. a Editor’s Note: Learn more about Medicare revalidation by joining your colleagues at AOPA’s “Mastering Medicare: Advanced Coding & Billing Techniques” seminar, March 4-5 in Atlanta. For more information, see page 34.
Devon Bernard is AOPA’s manager of reimbursement services. Reach him at dbernard@AOPAnet.org.
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Pathways to
Photo: Sashkin/www.bigstock.com
Mobility
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COVER STORY
By JILL CULORA
Orthotic advancements help stroke patients reclaim their independence
A
glimpse at Eric McHuron’s MRI— and the brain destruction caused by a stroke—is a telling one. The image shows a large section, nearly an entire side of the brain. It’s very light gray and lacking the detail shown in the darker side. This lighter section is the part of the brain damaged by the stroke. McHuron, 66, of San Francisco, is among the 85 percent of people who survive a stroke, but he also is among the 60 percent of that group who experience moderate to severe impairments requiring special treatment in a nursing home or other extended care facility. A stroke occurs when there is a sudden blockage of blood flow to a part of the brain or when a blood vessel in the brain bursts. It is the leading cause of serious long-term disability in the United States: Nearly 800,000 people suffer a stroke each year. High blood pressure, age, race, cholesterol, family history, and unhealthy lifestyles
are all risk factors. People who live in the “stroke belt”—a region in the southeastern United States—have the highest rate of stroke mortality. Treatment depends on the seriousness and the cause of the stroke, but, regardless of the severity, all require medical and therapeutic care, whether short- or long-term, aimed at restoring loss of movement, speech, and brain function. “Generally, with a stroke it’s unilateral involvement,” says Eric Weber, CPO, LPO, area clinic manager for Hanger Clinic in Seattle. “So, one side of the body is affected rather than both sides. There is so much more involved than foot drop because everything—from the ability to don and doff something to a caregivers group— involves a family that is truly [engaged] in the design and the care of whatever orthotic device that we make. And every stroke patient is different.”
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Motivation and activity levels combined with a patient’s age help determine the course of treatment. “With stroke patients, it is very traumatic because it can happen to somebody in their 20s, and they feel that basically their life is ruined,” says Bob Drillio, CO, owner of IAM Orthotics and Prosthetics. “[Orthotists] have to find a way to help them progress to remove themselves from rehab.”
in their hands and wrists. A small, handheld control unit communicates wirelessly with the orthosis, sending electrical impulses to the muscles that control hand and wrist function. “In terms of restoring function, most of that, at least at this point, is still in the lab,” says Weber. “But to be practical in a patient setting, that it’s paid for by U.S. insurance companies, we are probably a decade away.” Stroke patients typically have issues with a drooping shoulder—caused by weakness in the muscle and tendons that normally support the humerus bone in the shoulder socket—in addition to flexion contractures and balling of the fist, because tendons want to contract back to their primitive state following a stroke. Upperextremity orthotic braces and devices are designed to address a number of these issues, including increasing range of motion; immobilizing to help with tissue healing; blocking an unwanted movement; and aiding to reduce the long-term effects of contracture, which include disfigurement and loss of motion.
Lower-Extremity Othoses
Upper-Extremity Orthoses
A few companies are developing functional electrical stimulation (FES) devices for upper-extremity use that stimulate muscle contraction and could lead to an increase in function, strength, and movement, as well as a decrease in pain and spasticity.
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Advancements in the development of functional upper-extremity orthotic devices are, by and large, limited to new fabrics and materials coming to market that provide greater comfort and range of motion, and prevent deformities. Those materials include low-temperature thermo plastics and Kevlar and carbon fiber pre-preg, which are used to make custom fit orthoses for individual patients. A few companies are developing functional electrical stimulation (FES) devices for upper-extremity use that stimulate muscle contraction and could lead to an increase in function, strength, and movement, as well as a decrease in pain and spasticity. One such device is Bioness’s H200 Wireless System, which is worn on the forearm and is designed to help stroke patients regain function
The most common lower-extremity impairment for stroke patients is foot drop: an inability to turn the ankle and toes upward due to weak dorsiflexors. That condition significantly impacts a patient’s ability to ambulate, and, as such, much research is addressing this issue. “One of the major difficulties with stroke patients—especially in the foot complex—is that foot drop is for life,” says Drillio. “They do not usually [regain] any anterior tibialis control, and that is something we have to deal with basically for the rest of their life. “They don’t have the normal 20 degrees of dorsiflexion,” continues Drillio, “so they have a really short and unbalanced stride. And if that’s not treated quickly in the acute care stage to keep those contractures stretched out, it causes a real problem for the practitioners in the rehab setting and for physical therapists trying to figure out what to do.”
Medicare and some private insurance companies are reimbursing 90 to 100 percent, according to Glaister. Other lower-extremity orthotic devices for stroke victims include ones that use computer modeling and technology along with FES—a concept that has been around for a century. Those new devices can be programmed to coincide with a patient’s gait pattern and help prevent foot drop. “It’s a hybrid of therapy and orthotics because it’s not as much of a corrective device [as it is] a supplement to the patient’s existing muscle,” says Weber. These systems are small, easy to use, and customizable for individual
patients. Examples include Innovative Neurotronics’s WalkAide, an AA battery-powered, single channel stimulator that does not require orthotic or special shoes. It has a multifaceted computer software program that includes a pre-programmable exercise mode that allows patients to exercise muscles during rest mode. Another example, the Bioness’ Ness L300 Foot Drop System, has a gait sensor that automatically detects different surfaces and speeds, and sends signals to adjust stimulation, so the user has a more natural stride on various surfaces such as grass and sand.
Photo: Cadence Biomedical
IAM O&P has a patent-pending new ankle-foot-orthotic called the IAM Rocker Walk, which allows the normal rockers of the foot—heel compression and pronation at midstance and terminal stance—to function even in a neurologically deficit patient, like a stroke patient. “You can stimulate the rockers of the foot 10 years out to retrain the foot,” says Drillio, who has a number of his patients using the IAM Rocker Walk. He says the dynamic motion brace can help resolve other issues that restrict a normal gait pattern. When it comes on the market, the device will be an alternative to standard foot drop AFOs, which tend to be rigid and dictate how a foot reacts, says Drillio. “If you can let a foot move, you can stop a patient from hyperextending [as he or she would] in any other brace.” Hip weakness is another common issue with stroke patients that can affect gait, specifically at swing-through phase. “You can keep their toes neutral with an ESS or an AFO, but, if they have weakness in the hip flexors, they can’t lift their leg off the ground, and they can’t walk,” says Brian Glaister, PhD, president and CEO of Cadence Biomedical. The company’s new product, Kickstart Kinetic Orthosis, addresses that issue. Inspired by studying the tendons of a racehorse, the non-robotic Kickstart uses a long spring that runs from the hip down to the ankle. “When a user starts a step, the spring stretches and stores energy, and then, at the end of the step, all the energy comes back, and it helps propel them forward. But even more importantly, it helps them lift their leg off the ground, so they can swing through and take a full step,” says Glaister. “When the spring stretches, the patient doesn’t have to put any energy into it; it’s all captured by inertia. So, we’re capturing energy that is wasted and then returning it to do something useful with it.” Candidates for the Kickstart include stroke patients who specifically have hip flexion weakness. At $7,800 retail, the device is partially covered by
Diagram of the Kickstart Kinetic Orthosis
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Age, activity level, and motivation are key factors in determining how aggressive a stroke patient is treated.
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A popular therapeutic device used with stroke patients is the Lokomat treadmill, which uses robot-assisted technology to help train the brain and spinal cord with the patient in a body weight support system. “By taking weight off the patient, it really gets them used to moving again,” says Drillio. “The treadmill is so repetitious that the physical therapist can really look at the patient and figure out where they are having a problem.” Deciding which treatment path to take is really up to the patient. Treatment protocols help determine which “hot fires” to address first. “It’s amazing. If they come in a wheelchair or with a cane and their body might be contorted in a certain way, an orthotist’s first instinct is to line up and correct every part of the body into a neutral plane,” says Weber. “But it’s interesting that after you interview and get to know the person a bit better, their hot fire—the most important thing that they are coming to see you for—might not be what you are thinking of. It might be that they care about nothing else [but doing needlepoint]. A hot fire is such a subjective and different goal for everybody.”
Treatment Plans Age, activity level, and motivation are key factors in determining how aggressive a stroke patient is treated. But early orthotic intervention is the best treatment, especially to prevent and reduce deformities. Measurable outcomes are assessed by various physical trials and tests. “For a patient who is motivated and wanting to engage and return to the function that they had, no matter if they are wearing a brace or not, we put them on a far more aggressive [regimen], including therapy, maximum systems, and then bridge them into minimal assistance orthotics—pushing them to the limits,” says Weber. “[Sometimes a person] is out of it enough that they are not really aware of why they are here. In those protocols, the medical team might say, ‘All we really care about is preventing this foot from being fixed in plantar flexion.’ In such cases, we make [the patient] as comfortable as possible and prevent something from happening. As an orthotist, there might be things you want to do for this patient, but you can’t do them until the patient is ready.” Stroke patient McHuron is an example of a motivated patient. He was an avid hiker before his stroke in December 2003. Since then, he has worked hard at restoring function and returning to hikes and long walks with his wife, Carol.
Patient compliance is a big challenge, especially with stroke patients because the idea of wearing an orthotic can be more difficult for them to accept due to the sudden and unexpected onset of their condition. Slow improvements have given the couple much hope for the future, and, throughout the years, he has looked at new developments in orthotic devices as a pathway to improving lost function. Among the impairments caused by the stroke, McHuron has
difficulty speaking, caused by aphasia, and has foot drop with weak hip flexion. Over the years, he has used several devices—all helpful but either too expensive for purchase or limited in function. For the past nine months, McHuron has been wearing the Kickstart device, which he says increases his balance and ability to walk faster. It also has trained his right foot to straighten instead of turning outward while walking. As with all O&P devices, stroke orthotics are only effective when they are used. Patient compliance is a big challenge especially with stroke patients because the idea of wearing an orthotic can be more difficult for them to accept due to the sudden and unexpected onset of their condition. “All the technology, materials, and advancements that are out there don’t do the stroke patient any good if they stick it in their closet,” says Weber. “Orthotists, and the physician really need to come to an agreement with the patient, so they are onboard and willing to use the device as much as possible. The best device in the world that is not used is not doing anybody any good.” a Jill Culora is a contributing writer to O&P Almanac. Reach her at jillculora@gmail.com.
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The
ROI of CSR How caring about your world can help your bottom line
T By Deborah Conn
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he term “corporate social responsibility” (CSR) has been in the headlines a lot recently. Unfortunately, those reports often described the actions some companies fail to demonstrate. But what does CSR mean, exactly? “The idea is that companies care about the impact they are making internally and externally, and are not just focused on making a profit,” says Linda Gornitsky of LBG Associates, based in Stamford, Connecticut, who consults on corporate citizenship and community involvement programs. In its broadest sense, CSR includes every aspect of a company’s operations: from its governance and human resources policies to financial practices, environmental impact, and philanthropic activities. When done properly, CSR can benefit everyone involved—company, community, and employees—she says. “A lot of research has shown that consumers do value companies that are socially responsible and take this into consideration” when making purchasing decisions, says Gornitsky. But beyond increasing their customer base, business executives realize that giving back helps create healthy communities, and healthy communities lead to profitable companies.
Company Operations
Photo: Arizona AFO
Operating in an ethical manner, treating employees well, and minimizing one’s environmental impact are basic to CSR and are attributes of O&P companies of all sizes and levels of profitability. Minnesota-based Winkley Orthotics and Prosthetics, for example, posts its core values in every fitting room in every facility. Those eight values— service, consistency, respect, integrity, teamwork, accountability, prudence, and simplicity—“really drive everything we do,” says General Manager Terence Woodman, CO, BOCO. “Whether we are treating a patient, billing an insurance company, or working with a nonprofit, these are the basis of our actions.” Össur, a much larger, international company, has made a formal commitment to the UN Global Compact on Social Responsibility, a framework for businesses based on 10 principles in the areas of human rights, labor, the environment, and anti-corruption. Companies commit to publishing a description of how they have integrated the principles into their operations; Össur will be issuing its first CSR report in its 2012 annual report, which was not available at press time. Össur also has adopted the 14001 environmental management standard promulgated by the International Organization for Standardization (ISO) and implemented the first phase at its Icelandic headquarters in 2010. The company plans to introduce the
CSR COMPONENT:
COMMUNITY INVOLVEMENT
COMMUNITY NEEDS
BUSINESS GOALS
EMPLOYEE INTERESTS
YOUR BUSINESS OUTREACH STRATEGY Community Outreach standard to other locations, including in the United States, during the next two or three years. Fabtech Systems, based in Everett, Washington, uses the principles of lean manufacturing (see O&P Almanac, January 2013), which include a significant reduction of waste. The company’s commitment to finding non-hazardous solutions for fabrication both shrinks its environmental impact and creates a working environment that is more pleasant and safer for employees. “We’ve gone to nontoxic resins, nonflammable and non-acetone wipes, and odor-free bonding materials,” says Scott Wimberley, CPA, lean implementation officer and operations manager at Fabtech. For Wimberley, creating a less hazardous workplace was obvious: “I spend more time in my lab than in my living room, and I don’t want the life beaten out of me by the time I retire. I felt that some of the processes being used weren’t adequate.”
Another component of CSR could be called community involvement or outreach. Such programs can take several different forms, including cash contributions to nonprofits, product donations, and volunteerism. Larger O&P companies may engage in all three; smaller firms may find that making in-kind donations of components and materials, and providing volunteers are more affordable ways to get involved. Although some businesses prefer to keep their charitable work low profile, most welcome the effect that community involvement can have on their image and standing. “When your company gets known for doing good things, it spills over into enhancing your brand and your reputation,” says Gornitsky. In addition, community outreach can enrich professional relationships within an organization and create a more cohesive and satisfied workforce. To get the most benefit for both the community and the company, Gornitsky advises developing an outreach strategy. She recommends that philanthropic activities be aligned with the organization’s business goals, meet community needs, and address employee interests. “Where those circles overlap, that’s your program,” she says. FEBRUARY 2013 O&P Almanac
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Photo: U.S. Navy photo by Mass Communication Specialist 2nd Class Sean Furey/Released
Members of the Wounded Warrior Amputee Softball Team are introduced before a softball game against the Navy Commanders on Joint Base Pearl Harbor-Hickam.
Like many O&P businesses large and small, Össur supports organizations with a connection to its products, including the Wounded Warrior Amputee Softball Team, the Amputee Coalition of America, Stand TALL in Hong Kong, and the Iceland Disabled Sports Association. The company also partners with the Challenged Athletes Foundation in the United States, providing sports prosthetics and hosting amputee clinics throughout the country, such as those in 2012 that focused on lower-limb mobility. A new project for Össur is the Amputee Emotional Well-Being Initiative, which it has undertaken with the Amputee Coalition and the Johns Hopkins University School of Medicine, in Baltimore. Össur Americas made an educational grant for a pilot program to train prosthetists in assessing patients’ emotional health. The next phase will focus on dissemination of the program and identification of community mental health resources. “We hope that this program will help raise awareness of this often overlooked issue and directly support more prosthetists and their patients 26
O&P Almanac FEBRUARY 2013
in pursuing emotional and mental health, as well as physical wellness,” says Mahesh Mansukhani, president of Össur Americas. Winkley Orthotics and Prosthetics makes cash donations to a wide range of charities, many of which are related to its business—such as the Special Olympics and Capable Partners, a Twin Cities nonprofit that pairs hunting and fishing enthusiasts with physically challenged individuals— and some that are not, such as local organizations of police and firefighters. Support for programs that serve people with disabilities is a focus for Scheck & Siress, based in the Chicago area. The facility makes financial contributions to such groups as Adaptive Adventures, which provides progressive outdoor sports opportunities for children, adults, and veterans with physical disabilities and their families; Dare2Tri, an organization for active amputees founded by Scheck & Siress prosthetist Melissa Stockwell, CP; and Families of Amputees in Motion (FAIM), a nonprofit providing support and information to anyone affected by an amputation, whether through accident,
disease, or from birth. In addition to cash, the company often supplies volunteers for certain activities. Larger annual contributions help support a fall gala and therapeutic golf outing to benefit the Marianjoy Rehabilitation Hospital in Wheaton, Illinois. Gornitsky believes that companies can achieve more with fewer, larger financial contributions like these than when they “sprinkle” smaller amounts around more randomly. “Research has shown that’s not very effective,” she notes. Especially in urban areas, smaller donations don’t provide as much benefit and lack accountability, she says. But not every O&P facility is in a position to make large cash gifts, so donating unused or returned orthotic and prosthetic components and devices is a natural alternative. When two Scheck & Siress employees established a nonprofit called the Range of Motion Project (ROMP) to provide prosthetic care in Guatemala, the company contributed equipment and supplies. Cascade Orthopedic, based in Chico, California, donates “a vast amount of supplies,” says National Strategic Account Manager Brad Mattear, CPA, CFo. “We get some product returned to us that is not eligible for return to the manufacturer, or we have dead stock—items we can’t move anymore—and thus we donate those items to charity.” Providing human resources is another low-cost way to make a big difference. “Volunteerism is probably the easiest and most affordable thing to do,” says Woodman. “Honestly, individually a company can only do so much, but when you multiply that by all the employees, it can really add up.” And volunteerism offers “a ton of benefits for everyone,” says Gornitsky. “A lot of companies are using service for teambuilding and networking exercises. It’s also a great tool for attracting and retaining workers. They really appreciate the opportunity. In fact, I’ve heard employees in focus groups say they’ve stayed with a company because of its volunteer program.”
Scheck & Siress gives paid time off to three or four employees two or three times a year to volunteer with ROMP in Guatemala, says CEO James Kaiser, CP, LP. Every employee at Winkley Orthotics and Prosthetics is eligible for a paid 8-hour day each year to devote to volunteer work at a local nonprofit. The company also offers a full 40-hour week of pay to those who volunteer for Helping Hands of Haiti. For group volunteer activities, it’s important that the entire organization get involved, including senior staff, advises Gornitsky. “Especially in large companies, one thing employees particularly like is getting an opportunity to meet other people in the organization they might only talk to on the phone and to work right alongside a senior vice president shoveling dirt or painting a house.”
Opportunities for Giving Back For O&P facilities that would like to expand their community involvement, or for those that simply want to get started, charitable groups that provide O&P care would be a good place to start. One such organization is Prosthetika, a nonprofit founded by Jon Batzdorff, CPO, former owner of Sierra Orthopedic Lab, in Santa Rosa, California, and now a prosthetist at San Francisco Prosthetics and Orthotics. Like everyone who works for Prosthetika, Batzdorff volunteers his time to the organization, which aids physically disabled people in developing countries who need orthotic or prosthetic care. Currently, Prosthetika is involved in ongoing projects in Mexico, Bolivia, and Haiti. “We built a prosthetic facility in Haiti three years ago and hired local Haitian trainees,” Batzdorff explains. “We’re maintaining the facility, training local prosthetists, and providing supplies.” But he notes Prosthetika is careful not to undermine the work of local prosthetists: “We don’t offer free services where someone is there trying to make a living.”
O&P practitioners and others volunteer on missions to those locations, and manufacturers donate components and materials. Batzdorff cited Rudy Becker, president of Becker Orthopedic, based in Troy, Michigan, as among many contributors to Prosthetika. Becker has sponsored workshops and sent teams of experts to teach orthotics in developing areas, particularly Latin America. Another nonprofit that receives volunteer support and in-kind donations from O&P is Prosthetic Hope International, founded by Rob Kistenberg, MPH, CP, LP, FAAOP, co-director of the MSPO program at Georgia Institute of Technology. After volunteering for missions to Belize, Kistenberg started the nonprofit to help develop support for Project Hope Belize, the only prosthetic and orthotic clinics in that country. Kistenberg also founded the Prosthetic and Orthotic Component Clearinghouse (POCC) as a way to keep usable O&P goods out of landfills by making them available to nonprofit organizations, educators, and researchers. POCC collects O&P components and supplies for distribution to organizations and practitioners who have limited or no access to them. The clearinghouse is an easy way for O&P facilities and manufacturers to make tax-deductible product donations that reach those who need them. Being a good corporate citizen doesn’t require limitless cash resources or a complete overhaul of one’s business practices. Companies of any size can make a difference both within their own walls and in the wider community, small steps at a time. The CSR rewards can be as simple as knowing you’ve done the right thing or as tangible as a spike in new business from positive publicity. In either case, good corporate citizenship enhances the O&P industry and the world it inhabits. a Deborah Conn is a contributing writer to O&P Almanac. Reach her at debconn@ cox.net FEBRUARY 2013 O&P Almanac
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Facility Spotlight By Deborah Conn
DuPage River
The Healing Organization A small O&P business in Illinois strives to make life better for diabetics
John E. Rooney, CP, C.Ped., LO
Facility:
DuPage Prosthetic & Orthotic Services, Inc.
Location:
Lombard and Naperville, IL
Owner:
John E. Rooney, CP, C.Ped., LO
HISTORY:
25 years in business
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O&P Almanac FEBRUARY 2013
J
ohn E. Rooney, CP, C.Ped., LO, established DuPage Prosthetic & Orthotic Services in 1988 and has maintained his small, family-owned practice since then. Rooney, a graduate of the O&P program at Northwestern University, also holds a certificate in orthotics from the Dr. William M. Scholl College of Podiatric Medicine at Chicago’s Rosalind Franklin University and a prosthetic certificate in above-knee socket design (natural shape, natural alignment). Early in his career, Rooney worked as an orthotistprosthetist at Edward Hines, Jr., VA hospital outside of Chicago, where he served as a member of the amputee clinic under orthopedic surgeon and clinical director Michael Pinzur, MD. After five years of service, Rooney decided to open his own facility. DuPage P&O provides custom orthoses for adults and children, with a specialty in diabetic pedorthics, which accounts for about 80 percent of the business. The facility also offers upper and lower custom prosthetics, as well as post-mastectomy services by Karen A. Rooney, CMF, BOC, who is a certified mastectomy fitter.
DuPage P&O custom fabricates the majority of its devices, including the patented Ulcer Healing Orthosis (UHO). John Rooney invented the UHO to address patients with diabetic, neuropathic, charcot joint collapse, with foot deformity and plantar ulcer. Patients with peripheral neuropathy, a common side effect of diabetes, can develop foot ulcers that are hard to heal and often lead to amputation. Typically, doctors prescribe a wide variety of readymade ankle-foot orthoses, (AFOs); adjustable shoewear devices; or the gold-standard—serial casting of the lower leg—a technology from the 1960s to reduce pressure on the wound area. Patients are instructed to stay off their feet using a wheelchair, crutches, and/or walkers. Unfortunately, notes Rooney, “Even if the wound does heal, it usually recurs due to the weightbearing devascularization at the point of a bony protuberance of a plantar foot deformity, which needs a permanent support solution like the UHO. “The diabetic population has grown tremendously, and the AFO of choice was the CROW [charcot restraint orthotic walker], which I
“When patients use the ulcer healing orthosis and follow their doctor’s instructions, we see a complete healing success rate of about 85 percent.” —John E. Rooney, CP, C.Ped., LO
didn’t think was adequate for certain types of patients,” he says. “For one thing, it provides a temporary solution to a permanent problem. I’ve seen patients use a CROW bilaterally— what a ghastly thing to have to wear. I typically recommend them only for extreme ankle charcot collapse until they have reconstructive surgery.” According to Rooney, the custommade UHO is able to both support the lower leg and foot and accommodate one or more ulcers. Patients are encouraged to stand and walk,
SEPTEMBER 18-21, 2013 ORLANDO, FLORIDA, USA
Expand your knowledge, grow your market presence and advance your career at this unique, global gathering of high visibility and importance.
For more information, contact us at worldcongress@AOPAnet.org or visit www.opworldcongressusa.org.
World Congress Ad _half A4.indd 1
Deborah Conn is a contributing writer for O&P Almanac. Reach her at debconn@ cox.net.
Why you should plan to attend: •
Research and development expenditures in the United States are more than $95 billion, making the United States the leader in medical innovation and creating the ideal location for a unique gathering of high visibility and importance.
•
Superior Clinical Education featuring the best speakers from around the world. Hear from physicians, researchers, and top-notch practitioners.
•
Practical learning and live demonstrations.
•
Preparation for the massive changes that U.S. healthcare reform is sure to bring, and its influence on global health policy.
•
Networking with an elite and influential group of professionals.
•
Largest display of exhibits in the United States for the orthotic, prosthetic, and pedorthic profession
•
Ideal U.S. location chosen for travel ease and popularity.
Gaylord Palms Resort & Convention Center Don’t miss the opportunity to participate in an expanded National Assembly in 2013 as AOPA and partners from around the world work to create an O&P World Congress experience for practitioners in the Western Hemisphere and around the world.
with accommodative footwear, thus improving blood flow to the affected area and promoting healing. Rooney adjusts the device at weekly follow-up appointments to ensure proper support and patient compliance until the ulcer is completely healed. “When patients use the ulcer healing orthosis and follow their doctor’s instructions, we see a complete healing success rate of about 85 percent,” he says. DuPage P&O has remained successfully small for the past 25 years, expanding to open a satellite office about 15 miles away in Naperville, Illinois, but Rooney doesn’t rule out future growth. As for continuing the family business into the next generation, Rooney says, “If any of my four children or their spouses decides to enter the profession, I would be very proud. But the desire to enter the profession needs to come from within them.” a
FEBRUARY 2013 O&P Almanac
1/8/13 10:07 AM
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AOPA HEADLINES
AOPA WORKING FOR YOU
Timed to Avert Disaster The March 12-13, 2013, AOPA Policy Forum will focus on huge Medicare O&P fee schedule cuts and massive expansion of competitive bidding for O&P
I Thomas F. Fise, JD
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O&P Almanac FEBRUARY 2013
n his January Executive Director’s Letter, AOPA’s Tom Fise laid out precisely the multiple perils and challenges O&P would face during the next 60 days as Congress wrestles to take action on a host of issues. Last year’s battle on the debt limit ended up requiring $1 trillion in cumulative payment cuts over a 10-year period; that’s the sequestration you hear about under which Medicare takes a 2 percent across-the-board cut, and many other government services take a 10 percent cut. Those cuts are due to kick in on March 2, 2013. To make it an even more precarious world for O&P, Congress must take further budgetary action because the continuing resolution keeping the U.S. government operating expires in March—and that action could include additional Medicare cuts that would further impact the industry. All of these potentially damaging prospects motivated AOPA leadership to move the 2013 Policy Forum from its traditional mid-April date to mid-March. Moving up the Forum will give AOPA members a chance to further educate
their legislators about how changes to Medicare could affect our industry before the curtain comes down. Without a doubt, Congress will be operating in a crisis mode; thus, it will take unusually strong voices of reason to help Congress avoid making last minute, crunch budget decisions that could harm you and your business. For example, Congress could change the law to permit blanket competitive bidding for many O&P devices. Strong voices—such as the Center for American Progress (CAP)— are already out there on the other side of this issue, urging universal competitive bidding on all medical devices (including O&P) for Medicare beneficiaries with claimed savings of $38 billion per year. Uninformed as that view is, it garnered support in a Washington Post editorial in early January. AOPA and the Amputee Coalition sent a letter last month to every member of Congress explaining the disaster that would happen to Medicare patient care if that proposal were adopted.
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Shorty now available in heavy duty version rated to 300 pounds
The DuraShock has quickly become the industry standard for dynamic torque and shock absorption because of its high performance and durability. The DuraShock uses a titanium core in combination with a durable, yet pliable, geometric urethane coupling to provide a high degree of active performance for golfing, hiking, gardening, or simple everyday use.
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AOPA HEADLINES
AOPA WORKING FOR YOU
www.savewithups.com/aopa
It will take many boots on the ground—informed AOPA members and their patients—to persuade members of Congress to make sure amputees and those with limb impairments continue to receive the special care, fitting, and follow-up that ensures their maximum mobility and quality of life. We all have to make our case directly to legislators and their staffs: Orthotics and prosthetics are not canes, crutches, and wheelchairs—but rather sophisticated replacement and support devices for those who suffer traumatic injuries, serious disease, or birth limitations. Your Congressional delegation needs to be convinced that amidst the craziness that will prevail during the
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O&P Almanac FEBRUARY 2013
next few weeks, some clear heads must protect patient care. Only you, other O&P professionals, and your patients have the experience, credibility, and motivation to make that argument in the most convincing manner. AOPA members need to do whatever it takes to be in Washington, DC, by 12:00 p.m. on Tuesday, March 12, for extensive briefings on the issues and to receive pointers on how to make your case, and a tool kit of “survival” measures. Making contact with members of Congress must be the first priority for you and everyone in the field. This is not a “let George or Sally do it” time. It’s a potential do-or-die event for the future of O&P. AOPA’s lobbying team will schedule all your appointments for Wednesday, March 13, so you can use your time in the most productive manner. AOPA has prepared talking points that will give
you the ammunition you need to make O&P’s case. Speakers at the March 12 briefing will provide you with the tips and the means and resources to make your points with maximum effectiveness. Remember, because members of Congress always have many issues to consider, sometimes your best advocate may well be the staff healthcare specialist who can help move the marker in our favor. Make your plans now to join the movement that is the only assurance you have to preserve the best possible situation for you and your patients. It’s easy to register—just go to www. AOPAnet.org and select the “Legislative and Regulatory” pull-down menu, then click on “Policy Forum.” You’ll find everything you need to register and make hotel reservations at L’Enfant Plaza Hotel, just a convenient walk from Capitol Hill. a
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AOPA HEADLINES
AOPA 2013 Board Begins Term During AOPA’s 2012 National Assembly, AOPA members ratified an update to the organization’s bylaws. In particular, these changes altered the membership composition of AOPA’s board of directors. Under the revised bylaws, the following changes were effected: • The new board will be composed of two supplier directors, instead of one • Board members who represent members on the basis of their business’s number of patient-care facilities have been simplified to three categories, instead of five • The number of at-large directors has been reduced to two, instead of three • A clinical at-large director seat has been established • A health-care at-large director seat has been established. The members of the board who were elected during AOPA’s Annual Business Meeting began the 2012-2013 term on December 1, 2012. The 2012-2013 board includes: • Thomas F. Kirk, PhD, president • Anita Liberman-Lampear, MA, president-elect • Thomas V. DiBello, CO, FAAOP, immediate past president • Charles Dankmeyer, CPO, vice president
• • • • • • • • • • •
James Weber, MBA, treasurer Kel Bergmann, CPO, director Michael Hamontree, director Alfred E. Kritter, CPO, FAAOP, director Eileen Levis, director Ronald Manganiello, director Dave McGill, director Michael Oros, CPO, director Jeff Collins, CPA, supplier director Scott Schneider, supplier director James Campbell, PhD, CO, clinical at-large director.
AOPA President Tom Kirk, PhD, introduced the board, “This team that has been elected by AOPA’s membership is comprised of professionals who have extensive business and clinical experience and have demonstrated their commitment to the O&P industry. I look forward to serving with this distinguished panel as we begin a year that will demand hard work confronting threats on the state and national levels, and fighting to protect our patients and their access to quality care.”
Master Medicare: Advanced Coding & Billing Techniques Join your colleagues March 4-5, 2013, at the DoubleTree by Hilton Hotel Atlanta Airport for AOPA’s “Mastering Medicare: Advanced Coding & Billing Techniques” seminar. AOPA experts will provide the most up-to-date information to help O&P practitioners and office billing staff learn how to code complex devices, including repairs and adjustments, through interactive discussions and much more. Meant for both practitioners and office staff, this advanced two-day event will feature breakout sessions for these two groups to ensure concentration on material appropriate to each group. Basic material that was contained in AOPA’s previous Coding & Billing seminars has been converted into nine one-hour webcasts. Register for the webcasts on AOPA’s homepage. Register online for the “Mastering Medicare: Advanced Coding & Billing Techniques” seminar in Atlanta at www.bit.ly/AOPAatl, or contact Devon Bernard at dbernard@aopanet.org or 571/431-0854.
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O&P Almanac FEBRUARY 2013
AOPA HEADLINES
2013 AOPA Audio Conferences: Mark Your Calendar Educate yourself and your staff during one-hour sessions in the comfort of your office on the second Wednesday of each month at 1 p.m. EST. This series provides an outstanding opportunity for you and your entire staff to stay abreast of the latest hot topics in O&P, as well as gain clarification and ask questions. It’s the most cost effective way for each member of your business to earn CE credits.
2013 Topics February 13: Understanding the LSO/TLSO Medicare Policy March 13:
Contracting With the VA: Hints for Landing the Contract
April 10:
Handling Adversity: Coping With Difficult Patients
May 8:
Navigate the Maze: Get to Know the Appeals Process
June 12:
Clinical Documentation: Dos & Don’ts
July 10:
Networking for the Future: Building Relationships With Referrals
August 14:
Don’t Get Stuck With the Bill: Medicare Inpatient Billing
Buy the Series and Get Two FREE! Visit the AOPA Bookstore, buy the series, and get two audio conferences free. AOPA members pay $990 to participate in all 12 sessions ($1,990 for nonmembers). If you purchase the entire year’s worth of conferences, all conferences from months prior to your purchase of the set will be sent to you as CDs. Seminars are priced at just $99 per line for members ($199 for nonmembers).
September 11: Read Between the Lines: The Medicare Lower-Limb Prosthetic Policy October 9:
What’s the Word: A Health-Care Reform Update and What You Can Expect
November 13: Advocacy: A Potent Weapon for Change December 11: What’s on the Horizon: New Codes for 2014
Register online at www.bit.ly/2013audio. Contact Steve Custer with questions at scuster@AOPAnet.org or 571/431-0876.
Understanding the LSO/TLSO Medicare Policy— Join the Audio Conference February 13 Ever wonder what items require a PDAC coding verification? Ever have trouble determining who is responsible for payment? If you have ever faced these challenges, join AOPA February 13 for an AOPAversity Mastering Medicare Audio Conference. This conference will provide you with the tools to help answer most of your LSO/TLSO Medicare Policy questions. The following topics will be covered: • Learn when an LSO/TLSO is covered. • Learn the proper use of the CG modifier. • Learn who is responsible for payment. AOPA members pay just $99 to participate ($199 for nonmembers), and any number of employees may listen
on a given line. Participants 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 www.bit.ly/2013audio. Contact Steve Custer at scuster@AOPAnet.org or 571/431-0876 with registration questions.
FEBRUARY 2013 O&P Almanac
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AOPA HEADLINES
Contracting With the VA: Hints for Landing the Contract—Join the Audio Conference March 13 Learn how to prepare for contract opportunities with the U.S. Department of Veterans Affairs (VA)—and why this should be an important part of your business operation. Join AOPA March 13 for an AOPAversity Mastering Medicare Audio Conference. The following topics will be covered: • How should I prepare for contract opportunities? • How do I find available VA contracts? • How does the VA contract process work? • How are VA contracts administered? AOPA members pay just $99 to participate ($199 for nonmembers), and any number of employees may listen on a given line. Participants 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.
Discover Employment Opportunities at AOPA’s Online Career Center As an O&P professional, you can make a difference every day. Job opportunities abound throughout the country, and the need for O&P professionals is increasing rapidly. Currently, 100 percent of O&P program graduates find employment, and most choose to make it a lifelong profession. If you’re seeking employment, access the most recent jobs available. If you’re recruiting, reach the most qualified candidates by posting your job on AOPA’s Online Career Center. Visit http://jobs.AOPAnet.org, or email Stephen Custer at scuster@ AOPAnet.org with questions.
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O&P Almanac FEBRUARY 2013
Register online at www.bit.ly/2013audio. Contact Steve Custer at scuster@AOPAnet.org or 571/431-0876 with registration questions.
AOPA 2012 Operating Performance Report Available Are you curious about how your business compares to others? This updated survey will help you see the big picture. The Operating Performance Report provides a comprehensive financial profile of the O&P industry, including balance sheet, income statement, and payer information organized by total revenue size, community size, and profitability. The data was submitted by more than 130 patient-care companies, representing 1,050 full-time facilities and 68 part-time facilities. The report provides financial performance results as well as general industry statistics. Except where noted, all information pertains to fiscal year 2011 operations. Purchase the 2012 Operating Performance Report at the AOPA Bookstore, www.aopanetonline.org/store.
www.AOPAnet.org
Coding & Reimbursment Legislative & Regulatory Education FInd it at www.AOPAnet.org
Simple As :
1.
3.
2. Visit www.kiss-suspension.com or Call 410-663-KISS (5477) Š 2011, U.S. Patent, Patent Pending Worldwide KISS is a registered trademark
AOPA HEADLINES
O&P PAC Update 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*: • • • • • •
Robert E. Arbogast Mike Fenner, CPO, LPO Mark Maguire, CPO Eduardo Reyes, CPO Jeff Smith, CPO Jack Steele
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. *Due to publishing deadlines, this list was created on Jan. 3, 2013, and includes only donations received between Dec. 19, 2012, and Jan. 3, 2013. Any donations received or made after Jan. 3, 2013, will be published in an upcoming issue of O&P Almanac.
Coming Soon 2013 AOPA Products & Services Catalog
If You’re Paying More Than 1.9%, You’re Paying Too Much
AOPA’s mission is to work for favorable treatment of O&P business in laws, regulations, and services to help members improve their management and marketing skills, and to raise awareness and understanding of the industry and the association. AOPA is proud to announce the 2013 Products & Services Catalog is coming soon— check the AOPA website at www. AOPAnet.org.
AOPA has partnered with Bank of America Merchant Services to offer credit card processing rates as low as 1.9 percent to AOPA members. Many members are paying more than 2.5 percent, and if you’re handling $500,000 a year in credit card transactions, the 0.6 percent savings is like getting a 200 percent return on your membership dues investment. To enroll, contact 888/317-5402 or email tellmemore@bankofamericamerchant.com. AOPA encourages members to request an audit of a recent processing statement to identify the savings they would enjoy.
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O&P Almanac FEBRUARY 2013
Coding Questions Answered 24/7 AOPA members can take advantage of a “click-of-the-mouse” solution available at LCode-Search.com. AOPA supplier members provide coding information about specific products. You can search for appropriate products three ways––by L code, by manufacturer, or by category. It’s the 21st century way to get quick answers to many of your coding questions. Access the coding website today by visiting www.LCodeSearch.com. AOPA’s expert staff continues to be available for all coding and reimbursement questions. Contact Devon Bernard at dbernard@AOPAnet.org or 571/431-0854 with content questions.
24/7
AOPA Applications
Welcome new members!
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.
Alpha-Omega Orthotics & Prosthetics 308 N. Kentucky, Ste. 4 West Plains, MO 65775 417/257-7411 Fax: 417/881-8223 Category: Affiliate Member Parent Company: Alpha-Omega Orthotics & Prosthetics, Springfield, MO
JMS Plastics Supply 3535 Route 66 West, Bldg. 4 Neptune, NJ 07753 732/918-8115 Fax: 732/918-1131 Category: Supplier Member Steve Skesavage
Pacific Orthotics & Prosthetics 1005 W. Orangeburg Avenue, Ste. A Modesto, CA 95350 209/575-1063 Fax: 209/575-1065 Category: Patient-Care Member Sandy Vitale
Prosthetix Shop LLC 431 Ohio Pike, Ste. 124 S. Cincinnati, OH 45255 513/843-5126 Fax: 513/843-5164 Category: Patient-Care Member Aaron Moles
Rehab Systems Inc. 542 Addison Avenue W. Twin Falls, ID 83301 208/736-7330 Fax: 208/736-7332 Category: Patient-Care Member Peggy Perkins
Rehab Systems Boise Inc. 7446 W. Lemhi Street Boise, ID 83709 208/342-4104 Fax: 208/342-4106 Category: Affiliate Member Parent Company: Rehab Systems Inc., Twin Falls, ID
Sanford Health HealthCare Accesories LLC 1845 Highway 59, Ste. 100 Thief River Falls, MN 56701 218/683-2588 Fax: 218/683-2640 Category: Affiliate Member Parent Company: Sanford Health HealthCare Accessories LLC, Fargo, ND
Sanford Health HealthCare Accessories LLC 626 N. 6th Street Bismarck, ND 58503 701/530-0230 Category: Affiliate Member Parent Company: Sanford Health HealthCare Accessories LLC, Fargo, ND
Turlock Orthotics & Prosthetics 130 Regis Street, Ste. A Turlock, CA 95382 209/634-9021 Fax: 209/634-9023 Category: Affiliate Member Parent Company: Pacific Orthotics & Prosthetics, Modesto, CA a
Membership in AOPA is one of the best investments that you can make in the future of your company.
FEBRUARY 2013 O&P Almanac
39
Marketplace PEL Supply Offers Modular Dynamic AFO
Total Knee® by Össur®. Totally versatile.
PEL Supply is now offers the Modular Dynamic AFO from Fillauer. This extension device not only integrates all of the key features and benefits of the Centri Dynamic Walk, but it also offers better ground clearance, due to a slight toe pick-up, which prevents distal migration of the knee orthosis. The Modular Dynamic AFO features a thermoformable foot plate as well as a fully adjustable PEEK rod, available in either straight or dorsi-assist, which provide the user with unlimited active motion at the ankle joint, to accommodate virtually any terrain. Easily attachable to any knee orthosis, the Modular Dynamic AFO is available in men’s or women’s sizes— small, medium, and large. For more information on the Modular Dynamic AFO, or any of Fillauer’s other high-quality products, contact PEL Supply at 800/321-1264, fax 800/222-6176, email customerservice@pelsupply.com, or order online at www.pelsuppy.com.
With K2, K3, and K4 models to choose from, Total Knee enables a broad range of amputees to walk with a smooth, more natural, energy-efficient gait, enhancing their confidence and stability. Key features include geometric locking for stability, plus mid-swing shortening designed to prevent hip-hiking and reduce the chances of tripping. Each model fits a wide range of amputees and is lightweight and easy to cosmetically finish. To learn more about Total Knee by Össur, call 800/2336263 or visit www.ossur.com today.
new Triton family of feet from Ottobock Comfort, security, reliability! Now your patients have more options to meet the demands of their active lifestyle. The Triton Low Profile (LP) and the Triton Heavy Duty (HD) are especially robust and waterproof, ready for the most challenging conditions. Or, choose the lightweight Triton carbon fiber foot; the Triton Vertical Shock (VS); or the Triton Harmony® with integrated vacuum technology for outstanding flexibility and support. Contact your sales representative at 800/328-4058 or visit www.ottobockus.com.
Prepreg from Ottobock Give your patients the most advanced KAFO technology combined with the most advanced fabrication! Ottobock’s line of KAFOs is now available in prepreg, creating KAFOs up to 40 percent lighter than laminated alternatives. Prepreg also creates more consistent fabrication outcomes that avoid unwanted buildups. Ottobock Fabrication Services offers decades of expertise, exceptional customer service, and an unparalleled reputation for quality. Our expert services include water transfer, lamination, and prepreg carbon fiber. You can count on timely turnaround delivering the results you want. Visit www.ottobockus.com, or call 800/795-8846. 40
O&P Almanac FEBRUARY 2013
Patented KISS® Superhero™ Reusable Test Socket Plate The unique design of this plate allows for easy casting tape removal, without damage. Damage-free casting tape removal allows this plate to be reused, saving costs. Visit www.kiss-suspension. com or call 410/663-KISS for more information.
LimbLogic® Technology Evolves! WillowWood’s LimbLogic VS is a popular choice with clinicians to provide patients with elevated vacuum. Now WillowWood is making this product even better. The new LimbLogic features a small, Bluetooth® low-energy fob, inductive charging, and an improved four-hole controller design with fieldserviceable exhaust filter. The smaller, simplified fob is more intuitive to use and maintains the same functionality. Join us at the 2013 Academy Annual Meeting on February 20 for a half-day workshop. We’ll introduce new features of LimbLogic that build upon field-proven technology, making the system more robust and easier to use. For information, call 800/848-4930 or visit www.willowwoodco.com. a
JOBS
Find your region on the map to locate jobs in your area.
professionally and clinically, while being supported by outstanding clinical and operational teams, please apply. Competitive benefits package. To learn more about a career with Wright & Filippis, please visit our website at:
www.firsttoserve.com/careers/
- Northeast - Mid-Atlantic - Southeast - North Central - Inter-Mountain - Pacific
Classified rates Classified advertising rates are calculated by counting complete words. (Telephone and fax numbers, email, and Web addresses are counted as single words.) AOPA member companies receive the member rate. Member Nonmember Words Rate Rate 50 or fewer words $140 $280 51-75 words $190 $380 76-120 words $260 $520 121 words or more $2.25 per word $5.00 per word Specials: 1/4 page, color 1/2 page, color
$482 $678 $634 $830
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 scuster@ 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
North Central CO/CPO/C.Ped Saginaw, Madison Heights, and Kalamazoo, Michigan Wright & Filippis, a leader in the rehabilitative health-care field, currently has positions for dedicated and compassionate clinicians. There are two positions for certified orthotists with pediatric, and specifically helmet, experience (or wanting to develop these skills) in Saginaw and Madison Heights areas. The third position is for a CO/CPO/C.Ped in Kalamazoo, Michigan. There is an opening for a C.Ped in the Bad Axe and Cass City area as well. Individuals striving to excel 42
O&P Almanac FEBRUARY 2013
Southeast CO/BOCO or CPO/BOCOP Meridian, Mississippi Methodist Orthotics and Prosthetics, a division of Methodist Rehabilitation Center is looking for a certified orthotist or certified prosthetist/orthotist for our facility in Meridian, Mississippi. Located only minutes from the Alabama line, Meridian is a growing town with three major hospitals within a half-mile of our office. Meridian offers many outdoor activities and is only three hours from the Gulf Coast. Ideal candidate should be a self starter with solid fabrication skills who wants professional growth with an exciting orthotics and prosthetics company. Clinical skills in office and hospital environment as well as the ability to function as a team player are vital. Methodist Rehabilitation Center is a progressive orthotics and prosthetics facility with five locations throughout Mississippi and Louisiana. Competitive salary and benefits, including 403b retirement with employer matching, continuing education, paid vacation, and more. Please forward resumes in confidence to:
Chris Wallace, CPO, FAAOP Director—Department of Orthotics and Prosthetics 1 Layfair Drive, Ste. 300, Jackson, MS 39232 Fax: 601/936-8896 Email: cwallace@mmrcrehab.org
CO/CPO/C.Ped/Technicians Easley, South Carolina Immediate openings in a rapidly-growing, multilocation practice. We need individuals who are self-motivated with strong clinical skills. Must share our passion for providing exceptional patient care. We are centrally located in upstate South Carolina, offering convenient access to mountains, lakes, and coastal regions. Very competitive salary and benefits package offered. Come join our team and make a real difference in the prosthetic/orthotic community! Submit resumes to:
Fax: 864/855-9331 Email: scot@advancedpro.biz
JOBS
Pacific
Inter-Mountain
CO/CPO
CPO/LPO
Central Valley, California Competitive Western United States O&P business seeking a certified orthotist or certified prothetist/orthotist in the Central Valley of California (Fresno area). We are seeking a seasoned practitioner with experience in practice management, clinical expertise in outpatient and inpatient settings, and a willingness to work within a dynamic team. Unlimited business opportunities available in an expanding local market. Competitive salary, benefits, and bonus plan. Interested parties should email inquiries/resume to:
Beaumont, Texas Great opportunities await you in Texas. A Houston-based established practice is looking for a practitioner to run an affiliate office in Beaumont with an opportunity of ownership. If you like small communities with fabulous outdoor activities and a relaxed environment to operate out of, then this is your place. The ideal candidate is an energetic, self-starting, motivated practitioner who processes excellent patient-care and communication skills to conduct comprehensive patient evaluations to deliver the best in O&P services and follow-up patient care. If you have a great personality and can conduct in-services and marketing whilst practicing your craft, then this is your amazing opportunity. We offer a competitive salary and benefits including health-care coverage, continuing education, paid vacation, and more. Send resume to:
Fax: 888/853-0002 Email: jwiley@pacmedical.com
Email: LegFixr@aol.com
“ Six doctors came walking in my room, surrounded my bed and they told me I would not get up again.” Tina Mann Tina Mann
Today Tina Mann walks, hikes, rock climbs, bikes and lives life fully thanks to Hanger Clinic. She was so inspired by her experience that she became an orthotic resident with us.
Clinic Manager
Competitive salaries/benefits, continuing education, leading edge technologies, management opportunities and even paid leaves to assist in humanitarian causes, all are part of Hanger Clinic career offerings. • 4,500+ employees • 1,000,000+ patients treated annually • 270,000+ orthotic and prosthetic products View our current positions and apply online at: www.hanger.com/careers or scan the QR code.
Hanger, 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 Info, contact: Robert S Lin, MEd, CPO, FAAOP Director of Residency Training and Academic Programs, Hanger Clinic, Ph. 860.667.5304; Fax 860.666.5386.
Hanger, Inc. was recently named one of Forbes 100 Best Small Companies in America.
150 YEARS
700 CLINICS
Available Positions: Clinic Manager
Tacoma, WA Waterville, ME
Morgantown, WV Burnsville, MN
Orthotist
Mesa, AZ Methuen, MA Parker, CO Urbana, IL Fairfield, OH Hammond, IN
Jackson, MS Philadelphia, PA Glendale, AZ Springfield, IL Camp Hill, PA Beaufort, SC Columbia, MO
Prosthetist / Orthotist Kissimmee, FL Jacksonville, FL Olympia, WA Pensacola, FL Tallahassee, FL Longview, WA Richland, WA Portland, WA
Prosthetist
Waterbury, CT Brunswick, GA
Amherst, NY Johnson City, NY Grand Junction, CO Springfield, IL Holland, MI Buffalo, NY Mayfield Heights, OH Wilkes Barre, PA
Wichita, KS
1 VISION
FEBRUARY 2013 O&P Almanac
43
CALENDAR
■ YEAR-ROUND TESTING BOC Examinations. BOC has year-round testing for all of its examinations. Candidates can apply and test when ready, receiving their results instantly for the multiplechoice and clinical-simulation exams. Apply now at http:// my.bocusa.org. For more information, visit www. bocusa.org or email cert@ bocusa.org. ■ On-site Training Motion Control, Inc. On-site Training Course is focused on the expedited fitting of your first patient. Course Length: 3 days, CEUs: 19.5 hours (estimated). Recommended for prosthetists with a patient ready to be fit immediately. For more information, call 801/326-3434, email info@ UtahArm.com, or visit www. UtahArm.com.
■■
2013 ■ February 13 AOPAversity Audio Conference–Understanding the LSO/TLSO Medicare Policy. For more information, contact Stephen Custer at 571/431-0876 or scuster@ AOPAnet.org.
■ February 20 WillowWood 2013 Academy Technical Workshop. Orlando. Caribe Royale Orlando. 1 PM. Fitting and Operating the New LimbLogic System: Learn about new system features which build upon field-proven technology, making the LimbLogic more vigorous and easier to use. Includes new socket design techniques that can decrease fabrication time while increasing system’s longevity. Visit www.willowwoodco.com.
■ February 20-23 39th Academy Annual Meeting & Scientific Symposium. Orlando. Caribe Royale Orlando. Contact Diane Ragusa at 202/380-3663, x208, or dragusa@oandp.org. ■ February 28 WillowWood: LimbLogic® for Practitioners. Mt. Sterling, OH. Course focuses on the clinical aspects of LimbLogic from operation to appropriate usage. Work with patient models and complete a fully operational LimbLogic socket to an initial dynamic fitting stage. Credits: TBD. Registration deadline is Feb. 8, 2013. Contact 877/665-5443 or visit www.willowwoodco.com. ■ MARCH 1 COPA 3rd Annual Educational Event. CSUDH O&P Program. Long Beach, CA. Hotel Current. Attendees will be able to choose from one of three concurrent sessions: Prosthetic Workshop
SUPERCOURSE SPRING 2013
CALENDAR RATES Telephone and fax numbers, email addresses, and websites are counted as single words. Refer to www.AOPAnet.org for content deadlines. Words
Member Rate
Nonmember Rate
Color Ad Special: 1/4 page Ad.............. $482............................... $678 1/2 page Ad.............. $634............................... $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 scuster@AOPAnet.org. 44
O&P Almanac FEBRUARY 2013
■ March 1 ABC: Application Deadline for Certification Exams. Applications must be received by March 1, 2013, for individuals seeking to take the May 2013 ABC certification exams for orthotists, prosthetists, pedorthists, orthotic fitters, mastectomy fitters, therapeutic shoe fitters, and orthotic and prosthetic technicians. Contact 703/8367114, email info@abcop.org, or visit www.abcop.org/ certification.
Motion Control
PROMOTE Events in the O&P Almanac
25 or less................... $40..................................$50 26-50......................... $50..................................$60 51+................... $2.25 per word................$5.00 per word
& Lab, Orthotic Workshop & Lab, and the Clinical & Business Track Session. For all other additional information, contact COPA Executive Director & Lobbyist Bryce Docherty at 916/769-0573 or bryce@thedochertygroup.com.
MARCH 4 - 8, 2013
at Motion Control Headquarters, Salt Lake City, Utah • In-depth training of Utah Arm / U3+ / Hybrid Arm / ProPlus Terminal Devices • Hands-on experience with UI software - bring your Windows laptop •
An overview of the EXCITING Motion Foot with hydraulic ankle
• CEUs: 34 (estimated) awarded by ABC
Actual patient fittings using: Utah Arm 3+ / Hybrid Arm Li-Ion Battery, MC ETD or Hand, MC Wrist Rotator, TRIAD Preamps, Myolab II
PLUS Interfacing the Utah Arm with an ilimb Hand - Karl Lindborg from Touch Bionics
The 5-day SuperCourse is $1,350.00 For more information or to register for the SuperCourse, email: info@UtahArm.com
115 N. Wright Brothers Dr. • Salt Lake City UT 84116 Phone: 801.326.3434 • FAX: 801.978.0848 Toll Free: 888.MYO.ARMS • www.UtahArm.com
CALENDAR
MARCH 1 WillowWood: LimbLogic® for Technicians. Mt. Sterling, OH. The course focuses on elevated vacuum socket fabrication. Includes basic operation and hands-on fabrication of LimbLogic adapters. Work with patient models and fabricate a LimbLogic socket. Credits: TBD. Registration deadline is Feb. 8, 2013. Contact 877/665-5443 or visit www.willowwoodco.com. ■
■ MARCH 1-2 Oklahoma Association for O&P Annual Meeting. Tulsa, OK. Marriott Southern Hills. For more information, visit www.okaop.org or contact Jane Edwards at 888/388-5243 or email jledwards88@att.net. ■ MARCH 4-5 AOPA: Essential Coding & Billing Seminar. Doubletree by Hilton at Atlanta Airport. Atlanta. To register, contact Stephen Custer at 571/432-0876 or scuster@AOPAnet.org.
■ March 9-10 ABC: Orthotic Clinical Patient Management (CPM) Exam. University of Texas Southwestern Medical Center, Dallas. The application deadline for this exam was Jan. 1, 2013. Contact 703/836-7114, email info@abcop.org, or visit www.abcop.org/certification. ■ March 11-16 ABC: Written and Written Simulation Certification Exams. ABC certification exams will be administered for orthotists, prosthetists, pedorthists, orthotic fitters, mastectomy fitters, therapeutic shoe fitters, and orthotic and prosthetic technicians in 250 locations nationwide. The application deadline for these exams was Jan. 1, 2013. Contact 703/836-7114, email info@ abcop.org, or visit www.abcop. org/certification.
■ MARCH 13 AOPAversity Audio Conference– Contracting With the VA: Hints for Landing the Contract. For more information, contact Stephen Custer at 571/431-0876 or scuster@AOPAnet.org.
■ MARCH 15 Ohio O&P Association Meeting. Columbus, OH. Polaris Hilton. For more information, contact Dianne Farrabi at 614/659-0197. ■ MARCH 15-16 PrimeFare West Regional Scientific Symposium 2013. New Location: Denver. Denver Marriott City Center. Contact Jane Edwards at 888/388-5243 or visit www.primecareop.com.
March 15-16 ABC: Prosthetic Clinical Patient Management (CPM) Exam. University of Texas Southwestern Medical Center, Dallas. The application deadline for this exam was Jan. 1, 2013. Contact 703/836-7114, email info@abcop.org, or visit www.abcop.org/certification. ■
■ March 18 WillowWood: Alpha DESIGN® Liners. Mt. Sterling, OH. Halfday course teaches how to use OMEGA software files to create custom liners. Attendees can practice with all aspects of the software, including file import, liner creation, liner fabrication, and design liner options. Credits: TBD. Visit www. willowwoodco.com.
MARCH 19-21 WillowWood: OMEGA® Training. Mt. Sterling, OH. Course covers basic and advanced software tool use and shape capture with OMEGA Scanner. ‘By Measurement’ shape creation and custom liners discussed. Includes extensive hands-on practice in capturing and modifying prosthetic and orthotic shapes. Must be current OMEGA facility to attend. Credits: TBD. Visit www.willowwoodco.com. ■
■ MARCH 21-23 2013 Annual Meeting of the International AfricanAmerican Prosthetic Orthotic Coalition. Atlanta. Georgia Tech Hotel and Conference Center. Contact Tony Thaxton Jr. at 404/875-0066 or email thaxton.jr@comcast.net. Visit www.iaapoc.org for more information. ■ April 1 ABC: Practitioner Residency Completion Deadline for March Exams. All practitioner candidates have an additional 30 days after the application deadline to complete their residency. Contact 703/8367114, email info@abcop.org, or visit www.abcop.org/certification. ■ APRIL 4-6 Rehabilitation Institute of Chicago: Pediatric Gait Analysis: Segmental Kinematic Approach to Orthotic Management. Chicago. Featuring Elaine Owen. 21.25 ABC credits. Contact Melissa Kolski at 312/238-7731 or visit www.ric. org/education. ■ April 8-9 AOPA: Essential Coding & Billing Seminar. Columbus, OH. Hyatt Regency Columbus. To register, contact Stephen Custer at 571/431-0876 or
scuster@AOPAnet.org
■ APRIL 10 AOPAversity Audio Conference–Handling Adversity: Coping With Difficult Patients. For more information, contact Stephen Custer at 571/431-0876 or scuster@AOPAnet.org.
■ APRIL 19-21 National Pedorthic Services. Milwaukee. Hands-on Custom Foot Orthosis Fabrication Course. Credits: 18.25 ABC. Contact Nora Holborow at 414/438-6662, email nholborow@npsfoot.com, or visit www.npsfoot.com. ■ May 1 ABC: Application Deadline for Certification and Clinical Patient Management (CPM) Exams. Applications must be received by May 1, 2013, for individuals seeking to take the July 2013 ABC certification exams for orthotists, prosthetists, pedorthists, orthotic fitters, mastectomy fitters, therapeutic shoe fitters, and orthotic and prosthetic technicians or July/August CPM exams for orthotists and prosthetists. Contact 703/8367114, email info@abcop.org, or visit www.abcop.org/certification. ■ MAY 3-4 Northwest Continuing Education Conference. Bellevue, WA. Visit www. nwaaop.org for more information. ■ MAY 3-5 National Pedorthic Services— Educational Course. Milwaukee. A hands-on approach to footwear modifications. 19.25 ABC CEUs. For more information, contact Nora Holborow at 414/438-6662, email nholborow@npsfoot.com, or visit www.npsfoot.com. ■ MAY 8 AOPAversity Audio Conference–Navigate the Maze: Get to Know the Appeals Process. For more information, contact Stephen Custer at 571/431-0876 or scuster@AOPAnet.org.
■ APRIL 18-19 New York State AAOP: Chapter Meeting. Albany, NY. Albany Marriott. For more information, please visit www. nysaaop.org/.
FEBRUARY 2013 O&P Almanac
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CALENDAR
May 13-18 ABC: Written and Written Simulation Certification Exams. ABC certification exams will be administered for orthotists, prosthetists, pedorthists, orthotic fitters, mastectomy fitters, therapeutic shoe fitters, and orthotic and prosthetic technicians in 250 locations nationwide. The application deadline for these exams is March 1, 2013. Contact 703/836-7114, email info@abcop.org, or visit www. abcop.org/certification. ■
■ MAY 16-18 PA Chapter AAOP Spring Conference. Pittsburgh. Sheraton Station Square Hotel. Contact Beth Cornelius at 814/455-5383 or Joseph Carter Jr. at 814/455-5383.
MAY 16-18 Western Mid-Western Orthotics and Prosthetic Association. WAMOPA Annual Meeting. Reno, NV. Peppermill Resort & Casino. 24 CEU credits with the best value in our industry. Visit www.wamopa.com for program and golf tournament updates or call Steve Colwell at 206/440-1811. ■
■ June 1 ABC: Practitioner Residency Completion Deadline for March Exams. All practitioner candidates have an additional 30 days after the application deadline to complete their residency. Contact 703/836-7114, email info@abcop.org, or visit www. abcop.org/certification. ■ JUNE 12 AOPAversity Audio Conference–Clinical Documentation: The Dos & Don’ts. For more information, contact Stephen Custer at 571/431-0876 or scuster@ AOPAnet.org.
■ June 13-14 AOPA: Essential Coding & Billing Seminar. Renaissance Phoenix Downtown Hotel. Phoenix, AZ. To register, contact Stephen Custer at 571/431-0876 or scuster@ AOPAnet.org.
■ JULY 1 ABC: Application Deadline for Certification Exams. Applications must be received by July 1, 2013, for individuals seeking to take the September 2013 ABC certification exams for orthotists, prosthetists, pedorthists, orthotic fitters, mastectomy fitters, therapeutic shoe fitters, and orthotic & prosthetic technicians. Contact 703/836-7114, email info@ abcop.org, or visit www.abcop. org/certification. ■ JULY 8-13 ABC: Written and Written Simulation Certification Exams. ABC certification exams will be administered for orthotists, prosthetists, pedorthists, orthotic fitters, mastectomy fitters, therapeutic shoe fitters,
and orthotic and prosthetic technicians in 250 locations nationwide. The application deadline for these exams is May 1, 2013. Contact 703/8367114, email info@abcop. org, or visit www.abcop.org/ certification. ■ JULY 10 AOPAversity Audio Conference–Networking for the Future: Building Relationships with Your Referrals. For more information, contact Stephen Custer at 571/431-0876 or scuster@AOPAnet.org.
■ JULY 26-27 ABC: Orthotic Clinical Patient Management (CPM) Exam. Georgia Institute of Technology, Atlanta. The application deadline for this exam is May 1, 2013. Contact 703/836-7114, email info@ abcop.org, or visit www.abcop. org/certification.
www.LCodeSearch.com
24/7 Expert Coding Advice 24/7
• The O&P coding expertise you’ve come to rely on is now available whenever you need it. • Match products to L codes and manufacturers—anywhere you connect to the Internet. • This exclusive service is available only for AOPA members.
Log on to LCodeSearch.com and start today. Not an AOPA member? GET CONNECTED
Contact Lauren Anderson at 571/431-0843 or landerson@AOPAnet.org. Visit AOPA at www.AOPAnet.org.
Manufacturers: Get your products in front of AOPA members! Contact Joe McTernan at jmcternan@AOPAnet.org or 571/431-0811. 46
O&P Almanac FEBRUARY 2013
CALENDAR
■ August 14 AOPAversity Audio Conference–Don’t Get Stuck With the Bill: Medicare Inpatient Billing. For more information, contact Stephen Custer at 571/431-0876 or scuster@AOPAnet.org.
■ SEPTEMBER 11 AOPAversity Audio Conference–Read Between the Lines: The Medicare Lower-Limb Prosthetic Policy. For more information, contact Stephen Custer at 571/4310876 or scuster@AOPAnet.org.
■ September 18-21 O&P World Congress. Orlando. Gaylord Palms Resort. Attend the first U.S.-hosted World Congress for the orthotic, prosthetic, and pedorthic rehabilitation profession. To register, contact Stephen Custer at 571/4310876 or scuster@AOPAnet.org.
■ OCTOBER 9 AOPAversity Audio Conference–What’s the Word: A Healthcare Reform Update and What You Can Expect. For more information, contact Stephen Custer at 571/431-0876 or scuster@ AOPAnet.org.
November 13 AOPAversity Audio Conference– Advocacy: A Potent Weapon for Change. For more information, contact Stephen Custer at 571/4310876 or scuster@AOPAnet.org. ■
■ December 11 AOPAversity Audio Conference–What’s on the Horizon: New Codes for 2014. For more information, contact Stephen Custer at 571/431-0876 or scuster@ AOPAnet.org.
2016 2014
■ SEPTEMBER 15-18 99th AOPA National Assembly. Orlando. Gaylord Palms Resort. For more information, contact AOPA Headquarters at 571/431-0876 or info@AOPAnet.org. a
■ SEPTEMBER 3-6 97th AOPA National Assembly. Las Vegas. Mandalay Bay Resort & Casino. For more information, contact AOPA Headquarters at 571/431-0876 or info@AOPAnet.org.
2015 ■ OCTOBER 7-10 98th AOPA National Assembly. San Antonio. Henry B. Gonzales Convention Center. For more information, contact AOPA Headquarters at 571/431-0876 or info@ AOPAnet.org.
AD INDEX Company ALPS American Board for Certification in Orthotics, Prosthetics & Pedorthics College Park Industries Inc. DAW Industries Dr. Comfort Fillauer Hersco Ortho Labs KISS Technologies LLC Orthomerica Products Orthotic and Prosthetic Study and Review Guide Össur® Americas Inc. Otto Bock HealthCare PEL Supply
Page 13
Phone 800/574-5426
Website www.easyliner.com
15 33 41 5, C3 1, 31 9 37 C4
703/836-7114 800/728-7950 800/252-2828 800/556-5572 800/251-6398 800/301-8275 410/663-5477 800/446-6770
www.abcop.org www.college-park.com www.daw-usa.com www.drcomfortdpm.com www.fillauercompanies.com www.hersco.com www.kiss-suspension.com www.orthomerica.com
17 7 C2 2
800/233-6263 800/328-4058 800/321-1264
www.oandpstudyguide.com www.ossur.com www.ottobockus.com www.pelsupply.com
WillowWood
Insert
800/848-4930
www.willowwoodco.com FEBRUARY 2013 O&P Almanac
47
AOPA Answers
Supporting PDAC Answers to your questions regarding PDAC coding verification
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.
Which items require Pricing Data Analysis and Coding (PDAC) coding verification in order to be billed to Medicare?
A.
The following prefabricated spinal orthoses require PDAC coding verification: L0450, L0454-L0472, L0488-L0492, L0625-L0628, L0630, L0631, L0633, L0635, L0637, and L0639. In addition, any custom-fabricated spinal orthoses fabricated by a central fabrication facility or manufacturer described by the following codes also require PDAC coding verification: L0452, L0480-L0486, L0629, L0632, L0634, L0636, L0638, and L0640. If you fabricate a custom LSO or TLSO in-house and provide it directly to the patient, you don’t have to have the product verified by the PDAC. However, you must be able to provide a list of materials used and a description of your fabrication process, if requested. All prefabricated diabetic shoe inserts, A5512, must be reviewed and verified by the PDAC. Custom-fabricated inserts, A5513, also require
48
O&P Almanac FEBRUARY 2013
PDAC coding verification if fabricated by a central fabrication facility or manufacturer. If you fabricate custom inserts in-house and provide them directly to the patient, you don’t have to have the insert verified by the PDAC. However, you must be able to provide a list of materials used and a description of your fabrication process, if requested. A double-upright knee orthosis described by code L1845, a pneumatic knee splint described by code L4380, a cervical collar described by code L0174, and a functional electric stimulator described by code E0770 all require PDAC coding verification. In addition, a multiligamentous support described by code L1906 requires PDAC coding verification.
Q. A.
Is the patient’s diagnosis required to be on the final detailed written order?
According to the Medicare medical policies and the Medicare program Integrity Manual, the only elements that are required on the detailed written order are the following: • Beneficiary’s name • Physician’s name • Date of the order and the start date, if start date is different from the date of the order • Detailed description of the item(s) • Signature and signature date.
The diagnosis is not required; it is optional and you may include it if you choose. a
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