Telehealth for O&P
Keith Cornell
Description
Collection
Title:
Telehealth for O&P
Creator:
Keith Cornell
Date:
4/13/2020
Text:
Hi List
The COVID 19 pandemic is requiring all of us to practice social distancing to an unprecedented degree. We will undoubtedly get better at it as we go and will likely incorporate some of these new strategies into our daily lives after this pandemic is past. It's easy to imagine healthcare, education and many other industries making better use of video conferencing tools like Zoom and Gotomeeting as they find efficiencies with practice. Telehealth is here to stay not just because of COVID 19 but because technology makes it unnecessary for some face to face visits. I find more and more my patients are contacting me via my cell phone. I get emails, texts, images and documents sent for anything such as a quick thanks to an image of a new wound or skin condition and asking my advice. It's the fastest way to get my attention and saves everyone time especially when time is critical to prevent the patient's condition from deteriorating. The Covid 19 crisis only adds to the need for teleO&P care. I can often use telehealth technologies to advise a patient regarding many common issues such as: how to adjust their socket fit, modify their wearing time, clear jammed shuttle locks, correct donning issues, gait/ sequencing issues, rebooting their microprocessors or to seek medical help.
Telehealth for O&P is not new and will likely expand with the rest of healthcare. The issue is how we are reimbursed. We are not paid for our advice. We are paid for our devices and our specific time to adjust and repair them. This is an old paradigm from the days when we were not so clinically focused.
The Lower Limb Prostheses - Policy Article (A52496) is very clear on this issue. It says:
Time performing the following services (not all-inclusive) must not be billed using code L7520:
* Evaluation to determine the need for a repair or adjustment or follow-up assessment
* Evaluation of problems regarding the fit or function of the prosthesis
* General beneficiary education or gait instruction
* Programming of electronic componentry
*
* The time we take to provide these essential services has continued to grow and is essential to our care. We are the only ones who can provide these services.
Massachusetts Governor Charlie Baker ordered payors to expand access to telehealth services and protect healthcare providers< <URL Redacted> >. The most important provision states that all commercial insurers, self-insured plans, and the Group Insurance Commission to cover medically necessary telehealth services. The order specifies that all payers in the state are required to allow all in-network providers to deliver clinically appropriate, medically necessary covered services to members via telehealth. The order prevents payers from imposing restrictions on the technology used to deliver telehealth services and reimbursing services delivered via telehealth at a lower rate.
The NAAOP has recently affirmed that O&P care is an essential service so isn't it time to reconsider how we can be paid for our clinical advice? Is anyone aware of steps being taking in this regard? Is this the time to pursue it?
I'm curious to hear others opinion. Thanks to the list for the venue.
Keith Cornell CP
Cornell Orthotics & Prosthetics
The COVID 19 pandemic is requiring all of us to practice social distancing to an unprecedented degree. We will undoubtedly get better at it as we go and will likely incorporate some of these new strategies into our daily lives after this pandemic is past. It's easy to imagine healthcare, education and many other industries making better use of video conferencing tools like Zoom and Gotomeeting as they find efficiencies with practice. Telehealth is here to stay not just because of COVID 19 but because technology makes it unnecessary for some face to face visits. I find more and more my patients are contacting me via my cell phone. I get emails, texts, images and documents sent for anything such as a quick thanks to an image of a new wound or skin condition and asking my advice. It's the fastest way to get my attention and saves everyone time especially when time is critical to prevent the patient's condition from deteriorating. The Covid 19 crisis only adds to the need for teleO&P care. I can often use telehealth technologies to advise a patient regarding many common issues such as: how to adjust their socket fit, modify their wearing time, clear jammed shuttle locks, correct donning issues, gait/ sequencing issues, rebooting their microprocessors or to seek medical help.
Telehealth for O&P is not new and will likely expand with the rest of healthcare. The issue is how we are reimbursed. We are not paid for our advice. We are paid for our devices and our specific time to adjust and repair them. This is an old paradigm from the days when we were not so clinically focused.
The Lower Limb Prostheses - Policy Article (A52496) is very clear on this issue. It says:
Time performing the following services (not all-inclusive) must not be billed using code L7520:
* Evaluation to determine the need for a repair or adjustment or follow-up assessment
* Evaluation of problems regarding the fit or function of the prosthesis
* General beneficiary education or gait instruction
* Programming of electronic componentry
*
* The time we take to provide these essential services has continued to grow and is essential to our care. We are the only ones who can provide these services.
Massachusetts Governor Charlie Baker ordered payors to expand access to telehealth services and protect healthcare providers< <URL Redacted> >. The most important provision states that all commercial insurers, self-insured plans, and the Group Insurance Commission to cover medically necessary telehealth services. The order specifies that all payers in the state are required to allow all in-network providers to deliver clinically appropriate, medically necessary covered services to members via telehealth. The order prevents payers from imposing restrictions on the technology used to deliver telehealth services and reimbursing services delivered via telehealth at a lower rate.
The NAAOP has recently affirmed that O&P care is an essential service so isn't it time to reconsider how we can be paid for our clinical advice? Is anyone aware of steps being taking in this regard? Is this the time to pursue it?
I'm curious to hear others opinion. Thanks to the list for the venue.
Keith Cornell CP
Cornell Orthotics & Prosthetics
Citation
Keith Cornell, “Telehealth for O&P,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 6, 2024, https://library.drfop.org/items/show/254886.
