Re: Fw: Re: [OANDP-L] USA billing - covered???

Re: Fw: Re: [OANDP-L] USA billing - covered???

Levy, Charles Edward

11/8/2002

Dear Cindy,

The issue of power mobility and/or prosthesis is a very big issue. The fact
of the matter is that a prosthesis can allow transfers and limited mobility,
while power is necessary for extended mobility. It is not that unusual in
the VA for an amputee to get both. As you probably know, the criteria for
power in Medicare is that the patient is unable to walk or wheel in their
home environment. Outdoor environments are not considered at all. However,
this criteria is not applied to amputees. We do not restrict amputees from
getting prostheses because they can use crutches within the home.

The truth, in my opinion, is that power mobility is designed to get people
out of their homes and into the world, just like prostheses. Their are many
people who can benefit from a prostheses in the home, but are limited beyond
the home (cardiovascular disease, pulmonary disease, and a host of other
neurologic and musculoskeletal disorders.

Complexity of prosthetic components are approved based on the ability of the
amputee. a minimal ambulator gets minimal components, while someone with
greater health and vitality may be able to receive more sophisticated
components.

For power mobility, things are opposite: Those with the greatest
impairments have the greatest chance of getting the most sophisticated
equipment (within limits).

I see power mobility as just a bulky arthosis. FOr someone with a gait
impairment due to an amputation on one side and and a neurologic disorder
that causes a foot drop on the other side is not forced to choose between
either the prosthesis or the ankle-foot orthosis.

Why should the amputee who has a neurologic disorder that limits ambulation
due to weakness and fatigue have to choose between a prosthesis and the
powered-wheeled mobility orthosis?

Anyway, I think equipment ought to be available to treat impairments. I see
no inherent contradiction between needed a prosthesis and a power mobility
device.

I suppose that I am preaching to the choir.

Thanks for letting me vent.

I feel better now.

Charles E. Levy, MD

-----Original Message-----
From: <Email Address Redacted> [mailto:<Email Address Redacted>]
Sent: Thursday, November 07, 2002 2:34 PM
To: <Email Address Redacted>
Subject: Re: [OANDP-L] Fw: Re: [OANDP-L] USA billing - covered???


Well I for one would like a case (if there may be one) of a patient that has
an electric wheelchair AND prostheses..................I have a patient I
will be billing for and NEED TO KNOW NOW!!!! sorry about the Caps but this
is
urgent, and I would like something concrete not a Not Sure or Could be if
you know what I mean.

Thanks in advance

Cindy M
Millars Orthotic & Prosthetic, Inc
MCR Rescue Coordinator
<URL Redacted>

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