Re: L5930-High Activity Knee Control Frame- HCFA has deemed this a non-covered item as of 05-01-06

Re: L5930-High Activity Knee Control Frame- HCFA has deemed this a non-covered item as of 05-01-06

M. Britt Spears CPO

5/8/2006

Medicare had better be careful for what they wish. I would imagine that there is about to be a huge number of K 4 amputees out there. I beleive that the definition is about to become more loosely interpreted. We all know that the manufacturers aren't about to come off their prices. How sad for our field.
  That's very unfortunate.
  M. Britt Spears CPO for real....

Gregory M. Straub, CPO < <Email Address Redacted> > wrote:
  I have had about 20 replies. The change is that L5930 now requires a K-4 functional level to be a covered item by Medicare when previously it was covered for K3 and K4 functional levels. There are a lot more K3 than K4 Transfemoral amputees out there. My biggest concern is that many non high activity frames have weight limitations of about 220 pounds.The reason we provide high activity frames is often not only due to their activity level but due to their weight as well. We pay more for knees that include high activity frames as well as knees rated for heavier patients.. Are we to assume the liability for providing 221+ pounders with a frame rated only to 220#? Ossur's Total Knee 2000 vs. 2100 is one example.

Greg Straub, CPO


---- Original Message -----
From: Gregory M. Straub, CPO
To: <Email Address Redacted>
Sent: Wednesday, May 03, 2006 6:50 PM
Subject: L5930-High Activity Knee Control Frame- HCFA has deemed this a non-covered item as of 05-01-06


I just heard this from a reliable source. Can others confirm? Another stab to the heart of our industry.

Greg Straub, CPO


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