Durable Medical Equipment Resource Blog
Healthcare leaders recognize patients as their most important area of focus. At the same time, however, overseeing business needs like inventory management, reimbursement, price transparency and staff shortages are top priorities. Significant opportunities exist for orthopedic clinics and ASCs to leverage automation to address these issues – but choosing the right solution can be daunting.
For more information, please click here to read the entire Becker’s article
CGS wants to remind suppliers and providers that orthotic devices are not covered if they do not meet the coverage criteria outlined in the Local Coverage Determinations (LCDs) for the HCPCS code prescribed at the time of service.
Devices provided prior to the start of medical necessity (for example, before the surgery), will not meet the coverage criteria. After surgery, if there is documentation of the medical necessity for the orthotic device(s), you can provide the item, keeping in mind there are many other payment rules related to the claim.
For orthotic devices that require Prior Authorization (PA) (L0648, L0450, L1832, L1833, and L1851), do not submit PA requests prior to the start of medical necessity (for example, before the surgery). After surgery, if the medical record documentation shows an emergent need for the device(s), you can submit an expedited request. If an expedited request is not feasible, append the ST modifier to the claim to bypass PA. Claims submitted with the ST modifier are subject to 100% prepayment review.
The American Alliance of Orthopaedic Executives (AAOE) adds the MotionMD® software platform by DJO® to the Peer Review Program™ for orthopedic and musculoskeletal vendors, connecting members with industry professionals. The AAOE Peer Review Program™ has been established to evaluate vendors of orthopedic products, services, and solutions. Approved vendors have demonstrated a strong reputation for advancing orthopedic practice objectives.
Please click this link for more information. AAOE MotionMD
No healthcare organization can afford to waste money, time, or personnel on outdated systems. In this issue of Becker’s Health CareReview, learn how our MotionMD®, VeriPro®, and OaraScore® software solutions can help improve efficiency, security, and benefit the industry in an interview with EVP of Healthcare Solutions Steve Ingel. Please click here to read the entire article. Becker’s Healthcare Article
DME INFO 