Medicare and Static AFOs
Jim Thelen
Description
Collection
Title:
Medicare and Static AFOs
Creator:
Jim Thelen
Date:
9/13/2011
Text:
I am seeing a 51 yo male C-4 quad who has been wearing PRAFO style afo's for
many years for positioning and foot ulcer management and control. He is a
new patients to us and needs replacement afo's. I know the previous
fittings were billed to medicare and paid but I am not aware of how they
were billed.
Medicare states in their LCD for AFO's: [quote] Medicare does not reimburse
for a foot drop splint/recumbent positioning device (L4398) or replacement
interface (L4394). A foot drop splint/recumbent positioning device and
replacement interface will be denied as not medically necessary in a patient
with foot drop who is nonambulatory because there are other more appropriate
treatment modalities.
My question is: What are the other more appropriate treatment modalities?
Jim Thelen, CP, BOCO, LPO
Trinidad Medical Consultants
Dallas, TX
214-340-6200
Fax 214-340-2206
many years for positioning and foot ulcer management and control. He is a
new patients to us and needs replacement afo's. I know the previous
fittings were billed to medicare and paid but I am not aware of how they
were billed.
Medicare states in their LCD for AFO's: [quote] Medicare does not reimburse
for a foot drop splint/recumbent positioning device (L4398) or replacement
interface (L4394). A foot drop splint/recumbent positioning device and
replacement interface will be denied as not medically necessary in a patient
with foot drop who is nonambulatory because there are other more appropriate
treatment modalities.
My question is: What are the other more appropriate treatment modalities?
Jim Thelen, CP, BOCO, LPO
Trinidad Medical Consultants
Dallas, TX
214-340-6200
Fax 214-340-2206
Citation
Jim Thelen, “Medicare and Static AFOs,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/232948.
