Re: responses- pelite liner retraction
Matt Bailey
Description
Collection
Title:
Re: responses- pelite liner retraction
Creator:
Matt Bailey
Date:
8/21/2013
Text:
As many of us have received RAC audits on pelite liners due to too many
units, I wanted to share what I found.
The LCD (l11442) states : No more than two _*of the same*_ socket
inserts (L5656-L5665, L56732, L5679, L5681, L5683) are allowed
per individual prosthesis at the same time. (Bold and underline are
mine for effect)
So, its not more than two in total it more than two of the same. This is
the verbiage I used to respond to mine. Since the patient received gel
liners (2) and one pelite liner,
I contend we are in compliance. None of the rational of why the patient
needs it really matters to the RAC. So I didn't go there, just told them
I followed the rules.
I hope this helps!
If anyone sees this differently, I would love to know,
Thanks,
Matthew Bailey, LPO, FAAOP
President
Florida O&P Services
On 8/7/2013 5:34 PM, Joan Cestaro wrote:
> Thank you to all who responded. It sounds as though this was an
> auto-generated retraction for region C as all of my Me, too! responses
> were from Region C. Other regions are likely not far behind! The LCD
> states a maximum of 2 liners allowed with any prosthesis. My practitioner
> billed 2 gel liners in addition to the pelite one, so that explains it. I
> would venture to guess that most of the Me, too! responses will find a
> similar pattern. One responder did note an interesting point. It is nice
> that they retracted the lesser expensive liner instead of the more expensive
> one. I guess the under educated, under trained auditors worked to our
> advantage on this one. J
>
>
>
> Joan K. Cestaro, C.P.
>
>
>
units, I wanted to share what I found.
The LCD (l11442) states : No more than two _*of the same*_ socket
inserts (L5656-L5665, L56732, L5679, L5681, L5683) are allowed
per individual prosthesis at the same time. (Bold and underline are
mine for effect)
So, its not more than two in total it more than two of the same. This is
the verbiage I used to respond to mine. Since the patient received gel
liners (2) and one pelite liner,
I contend we are in compliance. None of the rational of why the patient
needs it really matters to the RAC. So I didn't go there, just told them
I followed the rules.
I hope this helps!
If anyone sees this differently, I would love to know,
Thanks,
Matthew Bailey, LPO, FAAOP
President
Florida O&P Services
On 8/7/2013 5:34 PM, Joan Cestaro wrote:
> Thank you to all who responded. It sounds as though this was an
> auto-generated retraction for region C as all of my Me, too! responses
> were from Region C. Other regions are likely not far behind! The LCD
> states a maximum of 2 liners allowed with any prosthesis. My practitioner
> billed 2 gel liners in addition to the pelite one, so that explains it. I
> would venture to guess that most of the Me, too! responses will find a
> similar pattern. One responder did note an interesting point. It is nice
> that they retracted the lesser expensive liner instead of the more expensive
> one. I guess the under educated, under trained auditors worked to our
> advantage on this one. J
>
>
>
> Joan K. Cestaro, C.P.
>
>
>
Citation
Matt Bailey, “Re: responses- pelite liner retraction,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/235530.
