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.
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
In response to the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS), the U.S. Surgeon General and many medical specialties such as the American College of Surgeons and the American Society of Anesthesiologists recommended interim cancelation of elective surgical procedures. Physicians and health care organizations have responded appropriately and canceled non-essential cases across the country. Many patients have had their needed, but not essential, surgeries postponed due to the pandemic. When the first wave of this pandemic is behind us, the pent-up patient demand for surgical and procedural care may be immense, and health care organizations, physicians and nurses must be prepared to meet this demand. Facility readiness to resume elective surgery will vary by geographic location. Please click on this link for a list of principles and considerations to guide physicians, nurses and local facilities in their resumption of care in operating rooms and all procedural areas.
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.