Microprocessor Knee and Aetna
Chris Phillips
Description
Collection
Title:
Microprocessor Knee and Aetna
Creator:
Chris Phillips
Date:
6/27/2014
Text:
Hi all,
I have a new T/F amputee, strong microprocessor candidate with Amp-nopro score of 31/39. Aetna has denied the microprocessor code in our pre-auth stating that they cover these knees for trauma and cancer patients but not vascular amputees. We are gearing up with the physician for the initial peer-to-peer review/redetermination. Has anyone run into this situation and if so, were you able to succeed in getting the knee covered? I'm trying to get all our ducks in a row prior to setting this call up....studies, patient activities, etc.
Thanks in advance
Chris
Chris Phillips, CPO
Prosthetist-Orthotist
Owner
Seacoast Orthotics and Prosthetics
155 Griffin Road Unit 2
Portsmouth, NH 03801
*: 603-294-0010
6: 603-294-0012
seacoastoandp.com
This e-mail, including attachments, is covered by the Electronic Communications Privacy Act, 18 USC 2510-2521, & the HIPAA regulations and, as such, is confidential & may be legally privileged. It is intended for the use of the individual or entity to which it is addressed & may contain certain information that is privileged, confidential & exempt from disclosure under applicable law. If the reader of this message is not the intended recipient or agent responsible for delivering or copying this communication & attachments, you are hereby notified that any retention, dissemination, distribution or copying of any of the contents are strictly prohibited. If you have received this communication in error, please reply to the sender & then delete it. Thank you for your cooperation.
I have a new T/F amputee, strong microprocessor candidate with Amp-nopro score of 31/39. Aetna has denied the microprocessor code in our pre-auth stating that they cover these knees for trauma and cancer patients but not vascular amputees. We are gearing up with the physician for the initial peer-to-peer review/redetermination. Has anyone run into this situation and if so, were you able to succeed in getting the knee covered? I'm trying to get all our ducks in a row prior to setting this call up....studies, patient activities, etc.
Thanks in advance
Chris
Chris Phillips, CPO
Prosthetist-Orthotist
Owner
Seacoast Orthotics and Prosthetics
155 Griffin Road Unit 2
Portsmouth, NH 03801
*: 603-294-0010
6: 603-294-0012
seacoastoandp.com
This e-mail, including attachments, is covered by the Electronic Communications Privacy Act, 18 USC 2510-2521, & the HIPAA regulations and, as such, is confidential & may be legally privileged. It is intended for the use of the individual or entity to which it is addressed & may contain certain information that is privileged, confidential & exempt from disclosure under applicable law. If the reader of this message is not the intended recipient or agent responsible for delivering or copying this communication & attachments, you are hereby notified that any retention, dissemination, distribution or copying of any of the contents are strictly prohibited. If you have received this communication in error, please reply to the sender & then delete it. Thank you for your cooperation.
Citation
Chris Phillips, “Microprocessor Knee and Aetna,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 24, 2024, https://library.drfop.org/items/show/236452.
