CMS Socket Replacement Audits
biotechofdurham
Description
Collection
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> >
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.