My Parapodium responses

My Parapodium responses

Michael Kiser,C.O.

2/13/2013

My original question was,

On Sat, Feb 9, 2013 at 5:01 AM, Michael Kiser,C.O. <
<mailto:<Email Address Redacted>> <Email Address Redacted> > wrote:

I have a little 3 year old Spina Bifida boy who I am going to fit with AFOs
and a Parapodium. I apparently have not fit one for a couple of years
because Variety Village no longer makes them but Fillauer does under the
name Parapod. My question is with coding. In the past I have used L1500 and
if it was a swivel walker I used L1502. Both of these codes expired on
December 31, 2011.

AOPA suggested:
E0641 Long Description: STANDING FRAME/TABLE SYSTEM, MULTI-POSITION (E.G.
THREE-WAY STANDER), ANY SIZE INCLUDING PEDIATRIC, WITH OR WITHOUT WHEELS

E0642 Long Description: STANDING FRAME/TABLE SYSTEM, MOBILE (DYNAMIC
STANDER), ANY SIZE INCLUDING PEDIATRIC


Neither of these codes seem appropriate to me.
The manufacturer suggests the L1502 expired code
Parapodiums apparently are not being used very often any more. What are you
using for your patients? I usually use parapodiums and if the child shows
motivation, ability, and ROM, I move them to RGOs.
Thank you in advance for your responses,
Mike Kiser, CO

Kiser's Orthotic and Prosthetic Services, Inc.

 

The responses supported my feeling that the Parapodium is not the treatment
of choice anymore.

I thank all that responded and the list for providing the forum for our O&P
question instant gratification.

 

The responses follow and the responders names were omitted as I do not have
permission to post them.

 

Check with the insurance provider if the L1502 is covered or not. Sometimes
private and other insurance companies keep other codes longer than Medicare

 

Morning Mike
VASI it distributed by Otto Bock Canada

 

Michael,

 

Yes, the Parapodium codes were eliminated because Medicare felt they were
falling below a level necessary to serve the code.

 

The only option is to use two HKAFO codes for right and left and indicate
these are most reasonable options.

 

Hope that helps,

 

 

Good questions. Looking forward to the responses.

 

Hi Mike:
You pose a good question here. We've discontinued the use of parapodiums as
an entry-level system for our younger patients with spina bifida, preferring
to now use wheeled standers. We order ours from Rifton:
< <URL Redacted>>
<URL Redacted>.

 

These offer considerably improved, more energy efficient, mobility for the
child while still providing the benefits of being in an upright position
with axial loading of their lower extremities. As you rightly pointed out
with one of the ideas behind a parapodium, these may precede the fitting of
an RGO, for those patients considered to be candidates. That said, we've
also found many of our patients will prefer this dynamic stander (Rifton's
term) as an alternative to an RGO for a longer period of time in the first
decade of life.

 

I hope you find this helpful and best of luck in supporting your patient and
family.

 

 

Dear Mike Kiser,

 

Here at Scottish Rite Hospital for Children we moved several years ago to
using the Rifton Dynamic Stander for our Spina Bifida kids who lack
ambulatory potential. We find these to be much more functional for the kids.
They can keep up with the family at the grocery store. We have even had kids
play T-ball in them. Unfortunately, I don't have any ideas about coding, as
we loan these to our patients/families indefinitely.

 

Good luck!

 

 

Well after reading the responses, I decided that on this high level Myelo.
Boy that the Rifton Dynamic stander made much more sense as his mobility
would be improved and safer. He is scheduled for his AFO fitting and I
contacted the Physician and Physical Therapist and asked for the order to be
changed and forwarded to the DME provider.