OPINION- DELIVERING A CUSTOM PROSTHETIC TO A SNF PATIENT

OPINION- DELIVERING A CUSTOM PROSTHETIC TO A SNF PATIENT

Elizabeth Roof

4/14/2021

Our office was referred by an orthopedic surgeon to fit a new amputee with a prosthesis and we have been working with the SNF facility that the patient is in currently to do so. It has come down to delivering out the item and we notified the facility that we are unable to deliver a prosthesis to a patient in a part A stay in a SNF bed and the facility is responsible for the cost of the item. We told them that we cannot give the patient the item until 2 days before he is discharged home and they don’t understand this. They want to be able to bill for therapy minutes on gait training and teaching him how to properly don/doff the prosthesis. The PT called the office today and stated that another local O&P facility in the area has delivered items out to them before for patients to complete therapy still in the SNF part A stay and she doesn’t understand why we don’t do the same. I’ve sent her all the items regarding proper Medicare billing practices for SNF stay patients on the Noridian Medicare Portal, but I am curious if any other facility has run into this same issue and what you’ve done to help educate other medical professionals on the billing guidelines we are to follow to stay compliant with Medicare. We of course want to continue to see the patient regarding his prosthesis as we have finished all fabrication, but also want to avoid improper billing procedures set forth by the payer.

Any tips or advice would be greatly appreciated!

Thanks in advance!

Liz Roof,
Billing Supervisor & Office Manager
15418 West Center Road
Omaha, NE 68144

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