No healthcare organization can afford to waste money, time, or personnel on outdated systems.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
The U.S. Centers for Medicare & Medicaid Services (CMS) will resume Medicare claims audits and prior authorization for power mobility devices and support surfaces on Aug. 3, according to an update to its FAQ on COVID-19 provider burden relief
SAN DIEGO–(BUSINESS WIRE)–DJO Global, Inc. (“DJO Global” or the “Company”), a leading global provider of medical technologies designed to get and keep people moving, today announced their MotionMD® software solution has received security certification from The Health Information Trust Alliance (HITRUST). The HITRUST CSF, a widely-adopted information privacy and security framework, helps support MotionMD’s compliance with certain healthcare standards by providing a secure and protected platform for sensitive and private healthcare patient information.
MotionMD underwent an in-depth review to obtain the HITRUST CSF Certification, which demonstrates that the software’s security controls are consistent with national and international security standards including ISO, NIST, PCI-DSS and HIPAA. The process normalizes security requirements and provides clarity and consistency, reducing the burden of compliance with the privacy and security regulations that apply to healthcare organizations.
We want our customers to feel safe when they provide sensitive healthcare information to our MotionMD platform,” said Terrence Weekes, DJO Global’s chief information security officer. “Since privacy and security are significant priorities for us, we continually strive to achieve the highest level of security for our systems. The HITRUST CSF Certification validates our efforts and provides an industry-recognized endorsement to our partners.”
MotionMD is an intuitive, web-based point-of-care solution designed to support claims management and inventory dispensing. This paperless software solution can help orthopedic clinics improve patient satisfaction, better manage billing compliance and streamline workflow by providing seamless interoperability with clinic records.
“I am proud of our team and the work they do each day to ensure patient health information is secure and protected within our network,” said Steve Ingel, president global bracing and supports. “Our industry leadership is further strengthened by our HITRUST CSF Certification and demonstrates we are a distinguished partner within the orthopedic device industry.”
About DJO Global
DJO Global is a leading global provider of medical technologies designed to get and keep people moving. The Company’s products address the continuum of patient care from injury prevention to rehabilitation after surgery, injury or from degenerative disease, enabling people to regain or maintain their natural motion. Its products are used by orthopaedic specialists, primary care physicians, pain management specialists, physical therapists, podiatrists, chiropractors, athletic trainers and other healthcare professionals. In addition, many of the Company’s medical devices and related accessories are used by athletes and patients for injury prevention and at-home physical therapy treatment. The Company’s product lines include rigid and soft orthopaedic bracing, hot and cold therapy, bone growth stimulators, vascular therapy systems and compression garments, therapeutic shoes and inserts, electrical stimulators used for pain management and physical therapy products. The Company’s surgical division offers a comprehensive suite of reconstructive joint products for the hip, knee and shoulder. DJO Global’s products are marketed under a portfolio of brands including Aircast®, Chattanooga, CMF™, Compex®, DonJoy®, ProCare®, DJO® Surgical, Dr. Comfort® and ExosTM. For additional information on the Company, please visit www.DJOglobal.com. DJO Global has extensive experience billing DME and is bringing this expertise to clients with MotionMD. For more information on MotionMD, visit www.djoglobal.com/motionmd.
The DME MAC Jurisdiction A has completed the widespread prepayment review of claims for Lumbar-Sacral Orthoses (HCPCS codes L0631 and L0637). These findings include claims processed primarily from March 2015 through May 2015. The review involved prepayment complex medical review of 1,384 claims submitted by 423 suppliers. Responses to the Additional Documentation Request (ADR) were not received for 582 (42%) of the claims. For the remaining 802 claims, 148 claims were allowed and 654 claims were denied resulting in a claim denial rate of 82%. The overall CDR was 81.8%. Please click here for entire report
We recently passed the one year mark of the roll-out of CMS’s changes to HCPCS coding for orthotics. If you have been tracking this issue, you know that CMS made significant changes to the coding structure by establishing two separate categories of HCPCS orthotic codes: Off-the-Shelf (OTS) and Custom Fitted (CST). We thought this would be a good time to review these changes and their implications.
As a reminder, the CMS definitions for OTS and CST orthotics are included below:
OTS Orthotics: Require minimal self-adjustment for appropriate use and do not require expertise in trimming, bending, molding, assembling, or customizing to fit the beneficiary. Minimal self-adjustment is an adjustment that the beneficiary, caretaker for the beneficiary, or a supplier of the device can perform and that does not require the services of a certified orthotist or an individual who has specialized training.
Custom Fitted Orthotics: Require fitting by someone with specialized education, training, and experience in fitting and certification and/or licensing.
If you are a DJO customer you have probably noticed that DJO now lists two recommended HCPCS codes on applicable product labels: one code for OTS and another for CST. Each customer should carefully review the CMS requirements to determine which is the most appropriate code to bill. Although, for now, the Medicare reimbursement for an OTS code is the same as a CST code, you must still meet the Medicare CST requirements when you bill a CST code. Failure to do so could subject you to Medicare repayments and even fines in the face of a Medicare audit.
For commercial payors, this change has created quite a bit of confusion. While most commercial payors are recognizing the new codes, there are still some that do not. We recommend that you check with your commercial payors to see how they are addressing the new coding structure. Depending on what you find out, you may want to check your payor contracts to determine if updates are indicated. For example, are the OTS codes listed and, if so, is there an associated fee schedule? And don’t forget to audit your payments to ensure you are getting paid appropriately by both Medicare and private payors.
If you would like more information or have questions about these changes please feel free to reach out to your local DJO representative.