Follow up OTS vs. Custom fit
Carey
Description
Collection
Title:
Follow up OTS vs. Custom fit
Creator:
Carey
Date:
3/10/2015
Text:
Guys,
If you received my message yesterday regarding the requirement of the fitting type to be in the physician's chart note, here is the response that I received from CGS.
**The recourse is probably with CMS, likely through the Provider Compliance Division. You can probably write a letter to Melanie Combs-Dyer outlining your position. Send it to:
Melanie Combs-Dyer
Centers for Medicare & Medicaid Services
7500 Security Blvd.
Mail Stop C3-09-27
Baltimore, MD 21244
If you are a practitioner or clinician that can articulate your viewpoint well through the written word, please join me in making her aware of this unreasonable requirement! We need to bombard her!
I have included my post from yesterday for your review:
** The new requirements regarding the level of fitting seem to be out of the scope of the physician:
When providing these items suppliers must:
· Provide the product that is specified by the ordering physician, i.e. (1) type of orthosis and (2) method of fitting and/or fabrication (OTS or custom fitted).
· Be sure that the medical record justifies the need for the type of product and method of fitting.
· Be sure only to use the code that accurately reflects both the type of orthosis and the appropriate level of fitting.
· Have detailed documentation in your records that justifies the code selected.for custom fitted versus OTS.
**I could understand this requirement if it was asking us (the supplier) to list the level of fitting on the DWO, but to ask for it to be in the medical record is too much. With all due respect, the physician does not know what level of fitting is required per patient. One of my Neurologist explained that he only had one semester of Orthotics throughout his entire school experience. How could a physician know the nomenclature of each Orthosis available today, much less the level of fitting required? At best this requirement would require an additional addendum in each chart note once our evaluation of the patient was complete. We would then have to go back to the physician and have him/her add the level of fitting that we (the Orthotist) feel is necessary. We are already going back to them for the DWO after obtaining a generic dispensing order. I feel that this is a gross overreach, is there any room to have this policy reviewed or to discuss this position?
Carey Jinright, LO, MSM
WDJD
Be an example, not an excuse!
Confidentiality Notice - The information contained in this e-mail and any attachments to it may be legally privileged and include confidential information. If you are not the intended recipient, be aware that any disclosure, distribution or copying of this e-mail or its attachments is prohibited. If you have received this e-mail in error, please notify the sender immediately of that fact by return e-mail and permanently delete the e-mail and any attachments to it. Thank you.
If you received my message yesterday regarding the requirement of the fitting type to be in the physician's chart note, here is the response that I received from CGS.
**The recourse is probably with CMS, likely through the Provider Compliance Division. You can probably write a letter to Melanie Combs-Dyer outlining your position. Send it to:
Melanie Combs-Dyer
Centers for Medicare & Medicaid Services
7500 Security Blvd.
Mail Stop C3-09-27
Baltimore, MD 21244
If you are a practitioner or clinician that can articulate your viewpoint well through the written word, please join me in making her aware of this unreasonable requirement! We need to bombard her!
I have included my post from yesterday for your review:
** The new requirements regarding the level of fitting seem to be out of the scope of the physician:
When providing these items suppliers must:
· Provide the product that is specified by the ordering physician, i.e. (1) type of orthosis and (2) method of fitting and/or fabrication (OTS or custom fitted).
· Be sure that the medical record justifies the need for the type of product and method of fitting.
· Be sure only to use the code that accurately reflects both the type of orthosis and the appropriate level of fitting.
· Have detailed documentation in your records that justifies the code selected.for custom fitted versus OTS.
**I could understand this requirement if it was asking us (the supplier) to list the level of fitting on the DWO, but to ask for it to be in the medical record is too much. With all due respect, the physician does not know what level of fitting is required per patient. One of my Neurologist explained that he only had one semester of Orthotics throughout his entire school experience. How could a physician know the nomenclature of each Orthosis available today, much less the level of fitting required? At best this requirement would require an additional addendum in each chart note once our evaluation of the patient was complete. We would then have to go back to the physician and have him/her add the level of fitting that we (the Orthotist) feel is necessary. We are already going back to them for the DWO after obtaining a generic dispensing order. I feel that this is a gross overreach, is there any room to have this policy reviewed or to discuss this position?
Carey Jinright, LO, MSM
WDJD
Be an example, not an excuse!
Confidentiality Notice - The information contained in this e-mail and any attachments to it may be legally privileged and include confidential information. If you are not the intended recipient, be aware that any disclosure, distribution or copying of this e-mail or its attachments is prohibited. If you have received this e-mail in error, please notify the sender immediately of that fact by return e-mail and permanently delete the e-mail and any attachments to it. Thank you.
Citation
Carey, “Follow up OTS vs. Custom fit,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/237283.
