CMS Socket Replacement Audits

biotechofdurham

Description

Title:

CMS Socket Replacement Audits

Creator:

biotechofdurham

Date:

5/11/2021

Text:

Aside from CMS Supplier Manual verbiage, we don't have clear criteria for
socket replacement from CMS (eg - quantified threshold for volume loss /
increases) the current audit criteria seems a bit nebulous. I was hoping
that those who have received judgements thus far would be willing to share
some of the criteria set forth by CMS to date. Specifically: Key elements
to their required CPO documentation. What did you submit? If you received a
denial - what do you think was missing? As an example, our practice has
submitted: 1) Evaluation, 2) Measurements quantifying anatomical change in
the residuum, 3) AMPro, 4) Physician Visit notes corroborating our findings.

Thanks in advance. I will share the responses.

- Mike

--

Michael Astilla, MS | President, Bio-Tech Prosthetics and Orthotics of
Durham, Inc.
Board Certified Prosthetist - Orthotist
<URL Redacted>
Instagram: @biotechnc < <URL Redacted> >

                          

Citation

biotechofdurham, “CMS Socket Replacement Audits,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/255377.