Responses to MPKs for K2 population and new clinical practice guidlines
Gary Wall
Description
Collection
Title:
Responses to MPKs for K2 population and new clinical practice guidlines
Creator:
Gary Wall
Date:
2/18/2019
Text:
Thanks to all who responded to my original post.
My question:
We all know that most insurance plans still consider a K3 functional level as a prerequisite for microprocessor technology. Has anyone had success obtaining authorization and then payment for MPK delivery to a K2 patient given the fair body of knowledge that says this should be the norm?
My conclusion from the responses:
It seems like one could get approval and payment on MPKs for the K2 amputee but the results are highly variable and it depends on insurance plans. Prior authorization is a necessity and citing studies can bolster your chance of success. I would like to think that our organizational bodies are making this a priority and are making a case to Medicare for coverage. Maybe this should be a topic of discussion at the next national meeting?
The responses:
I have had a good bit of success regarding this issue. Typically citing the works of many studies that suggest the benefits of mpk in general and fall Prevention and stumble recovery specifically in the K2 pop. In the prior authorization phase especially.
Having a hard time even getting paid for K3’s.
Please post your responses. Would like to know ANY ideas.
Yes certain insurances do allow for K2.
Have to know their policy article and then meet that requirement
Thanks again!
Gary L. Wall, MSPO, C.Ped, CFo.
Del Bianco Prosthetics and Orthotics
3410 Executive Dr. Suite 203
Medical Office Building 1
Raleigh, NC 27609
My question:
We all know that most insurance plans still consider a K3 functional level as a prerequisite for microprocessor technology. Has anyone had success obtaining authorization and then payment for MPK delivery to a K2 patient given the fair body of knowledge that says this should be the norm?
My conclusion from the responses:
It seems like one could get approval and payment on MPKs for the K2 amputee but the results are highly variable and it depends on insurance plans. Prior authorization is a necessity and citing studies can bolster your chance of success. I would like to think that our organizational bodies are making this a priority and are making a case to Medicare for coverage. Maybe this should be a topic of discussion at the next national meeting?
The responses:
I have had a good bit of success regarding this issue. Typically citing the works of many studies that suggest the benefits of mpk in general and fall Prevention and stumble recovery specifically in the K2 pop. In the prior authorization phase especially.
Having a hard time even getting paid for K3’s.
Please post your responses. Would like to know ANY ideas.
Yes certain insurances do allow for K2.
Have to know their policy article and then meet that requirement
Thanks again!
Gary L. Wall, MSPO, C.Ped, CFo.
Del Bianco Prosthetics and Orthotics
3410 Executive Dr. Suite 203
Medical Office Building 1
Raleigh, NC 27609
Citation
Gary Wall, “Responses to MPKs for K2 population and new clinical practice guidlines,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/209382.
