Fwd: [OANDP-L] bilateral BK

Fwd: [OANDP-L] bilateral BK

John P Atkinson Cpo

____________________________________
 From: <Email Address Redacted>
To: <Email Address Redacted>
Sent: 09/15/2008 10:30:59 A.M. Eastern Daylight Time
Subj: RE: [OANDP-L] bilateral BK


This is a very sticky situation that I have dealt with a couple of
times. It is not written that they cannot have both, but neither is it
listed that they can have both.

Medicare policy states that in order to obtain a Power Wheelchair:
The patient has a mobility limitation that significantly impairs his/her
ability to participate in one or more mobility-related activities of
daily living (MRADLs) such as toileting, feeding, dressing, grooming,
and bathing in customary locations in the home. A mobility limitation is
one that:
* Prevents the patient from accomplishing an MRADL entirely, or
* Places the patient at reasonably determined heightened risk of
morbidity or mortality secondary to the attempts to perform an MRADL; or
* Prevents the patient from completing an MRADL within a reasonable time
frame.
B) The patient's mobility limitation cannot be sufficiently and safely
resolved by the use of an appropriately fitted cane or walker.
C) The patient does not have sufficient upper extremity function to
self-propel an optimally-configured manual wheelchair in the home to
perform MRADLs during a typical day.

That being said, the policy does not state that the patient cannot
perform MRADLs, but is limited. An example would be if your patient was
ambulatory using a walker, he would still be significantly impaired in
his MRADLs because the walker would interfere with his ability to
participate MRADLs because he would not being able to carry items while
walking with the walker.

The best case is actually for your patient to receive his prostheses
first then obtain the wheelchair to assist him in his MRADLs.


Thank You,
Jessica Fachini
The Surgical Clinic
Prosthetic Administrator

-----Original Message-----
From: Orthotics and Prosthetics List [mailto:<Email Address Redacted>] On
Behalf Of John P Atkinson Cpo
Sent: Friday, September 12, 2008 9:36 AM
To: <Email Address Redacted>
Subject: [OANDP-L] bilateral BK

I have a BK patient who was recently made a bilateral BK amputee. He
is
looking at an electric wheelchair for now and plans on later, after
healing, to
obtain new prosthesis(s).
I remember reading, somewhere, if a patient has been approved and
received
an electric wheelchair he will not be approved for new prosthesis.
Reason
being Medicare does not approved an electric wheelchair for an
ambulatory
patient. The patient's wife call Medicare's help line and was told this
was not
the case and that he would qualify for both items, wheelchair and
prosthesis.
My obvious question is , What experience has anyone had on this
situation?

John Atkinson LPO
<Email Address Redacted> (mailto:<Email Address Redacted>)



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