USA billing - Preparatory sockets
Ted A. Trower
Description
Collection
Title:
USA billing - Preparatory sockets
Creator:
Ted A. Trower
Date:
3/6/2001
Text:
My original question was:
In the recent posting of the response summary [OANDP-L] Responses: AK
Flexible Socket Material several of the responses described using roll-on
suspension liners in preparatory prostheses. I agree that this makes a lot
of sense and it has worked well when I have done it.
Unfortunately Medicare has seen fit to exclude roll-on suspensions from use
with preparatory sockets. How do you deal with this problem?
-----------------------------------
The responses I've received follow:
-----------------------------------
>Don't do preparatorys. Do modular definitives and replace the sockets. Jim
>
-----------------------------------
>Provide only definitive prostheses and advise the client as why we do this,
>Then at 4-8 months, do a skt. repl. and a new cover. I haven't provided a
>temp. pros. for several years.
>
-----------------------------------
>Dear Ted
>They only exclude the use of suction liners on Trans tibial prepatory
>sockets, not Transfemoral.
>
-----------------------------------
>You are correct that Medicare does not allow certain procedures in
> conjunction with base codes for preparatory. Why not provide a definitive
> prosthesis and when volume has stabilized, provide a socket replacement?
> That allows you to provide the type prosthesis most appropriate for the
> patients needs as well as receiving adequate reimbursement. Use of
> endoskeletal componentry would provide the opportunity to adjust the
> prosthesis in a cost effective manner when changes were indicated and/or major
> component replacements(i.e. socket) were necessary.
-----------------------------------
So what reaction do folks have to these suggestions that what amounts to a
preparatory prosthesis be billed as a definitive? Just what do you see as
the difference between the two?
Ted A. Trower C.P.O.
A-S-C Orthotics & Prosthetics
Jackson, MI, USA
In the recent posting of the response summary [OANDP-L] Responses: AK
Flexible Socket Material several of the responses described using roll-on
suspension liners in preparatory prostheses. I agree that this makes a lot
of sense and it has worked well when I have done it.
Unfortunately Medicare has seen fit to exclude roll-on suspensions from use
with preparatory sockets. How do you deal with this problem?
-----------------------------------
The responses I've received follow:
-----------------------------------
>Don't do preparatorys. Do modular definitives and replace the sockets. Jim
>
-----------------------------------
>Provide only definitive prostheses and advise the client as why we do this,
>Then at 4-8 months, do a skt. repl. and a new cover. I haven't provided a
>temp. pros. for several years.
>
-----------------------------------
>Dear Ted
>They only exclude the use of suction liners on Trans tibial prepatory
>sockets, not Transfemoral.
>
-----------------------------------
>You are correct that Medicare does not allow certain procedures in
> conjunction with base codes for preparatory. Why not provide a definitive
> prosthesis and when volume has stabilized, provide a socket replacement?
> That allows you to provide the type prosthesis most appropriate for the
> patients needs as well as receiving adequate reimbursement. Use of
> endoskeletal componentry would provide the opportunity to adjust the
> prosthesis in a cost effective manner when changes were indicated and/or major
> component replacements(i.e. socket) were necessary.
-----------------------------------
So what reaction do folks have to these suggestions that what amounts to a
preparatory prosthesis be billed as a definitive? Just what do you see as
the difference between the two?
Ted A. Trower C.P.O.
A-S-C Orthotics & Prosthetics
Jackson, MI, USA
Citation
Ted A. Trower, “USA billing - Preparatory sockets,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/216245.
