Bilateral lower extremity functional classification
Gregory Straub
Description
Collection
Title:
Bilateral lower extremity functional classification
Creator:
Gregory Straub
Date:
8/16/2015
Text:
Listserve,
Two bilateral transtibial patients that I provided K3 feet for but billed
using the modifier K2 recently got denied. Both are experienced
wearers. Clinically the K3 feet allow them to ambulate faster, more
comfortably and using less energy than any K2 feet available. I provided
the K3 feet based on the following:
The Medicare local coverage determination (LCD) for lower limb prostheses
(L11442) effective 01-01-15 states that “It is recognized, within the
functional classification hierarchy that bilateral amputees often cannot be
strictly bound by functional level classification”.
I interpret this to mean that bilateral amputees who benefit from K3
prosthetic feet should have them covered even though they have a K2
functional classification.
Is my interpretation incorrect? What am I missing here? Is Medicare going
back on it's word?
Gregory M. Straub, CPO
Asheville, NC
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Two bilateral transtibial patients that I provided K3 feet for but billed
using the modifier K2 recently got denied. Both are experienced
wearers. Clinically the K3 feet allow them to ambulate faster, more
comfortably and using less energy than any K2 feet available. I provided
the K3 feet based on the following:
The Medicare local coverage determination (LCD) for lower limb prostheses
(L11442) effective 01-01-15 states that “It is recognized, within the
functional classification hierarchy that bilateral amputees often cannot be
strictly bound by functional level classification”.
I interpret this to mean that bilateral amputees who benefit from K3
prosthetic feet should have them covered even though they have a K2
functional classification.
Is my interpretation incorrect? What am I missing here? Is Medicare going
back on it's word?
Gregory M. Straub, CPO
Asheville, NC
********************
To unsubscribe, send a message to: <Email Address Redacted> with
the words UNSUB OANDP-L in the body of the
message.
If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
Paul E. Prusakowski,CPO at <Email Address Redacted>
OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list. Professional credentials
or affiliations should be used in all communications.
Citation
Gregory Straub, “Bilateral lower extremity functional classification,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 24, 2024, https://library.drfop.org/items/show/237558.
