Fwd: Coding
Michael thomas Wilson
Description
Collection
Title:
Fwd: Coding
Creator:
Michael thomas Wilson
Date:
4/5/2022
Text:
Good afternoon O&P,
Five prosthetics clinicians responded to below question. Two suggested additional L5984 not applicable to base 5979, two suggested otherwise and one suggested applicability is entirely dependent of clinical evaluation, more specifically how might pressure/energy absorption/transfer rate effect mechanical/physiological interfacing. Withholding my own opinion, I would like to comment on combination plausibility from historical perspective.
USMC commercialized Star transverse torque absorbers in mid 60's and as one respondent noted incorporated at either end of pylon. Design included vertical mechanical axis twisting inside co-axial elastic coupling sleeve with dedicated coding 5984. In 1979, I was issued patent # 4,134,159 describing same twisting mechanism proximal housing monolithically incorporated into thermoset sockets; dedicated coding 5986 (Patent was assigned to Medical Center Prosthetics, Houston Tx. thus coding nomenclature MCP or equal). Both 5984 and 5986 facilitate transverse motion around a vertical mechanical axis, provide 10 or more deg. of rotation and functions independently of ankle dorsi/plantar flexion and pronation/supination. Appearance of 5979 coding (All LLP DR prosthetics, one piece, multi-axial) coincides with but not dedicated to College Park original dynamic (DR) response foot (phone conversation with College Park 4/4/22). Among other factitious mechanical kinesiological features,, transverse motion occurs in concert with ankle inversion/eversion or frontal plain motion. Incidentally, Merriam-Webster defines multi as many, multiple, much, more than two, more than one.
In 1994, Mark Smith CP (Ret. Knit-Rite) and I conferred with Medicare additional and dedicated coding 5975 combing uni-axial ankle with base coding 5972 (elastic keel) and additional coding 5984 with elastic keel provided tibial torsion be managed independently of ankle coronal/frontal motion. More recently I patented and commercialized DR articulated/elastic keel feet facilitating motion in coronal plain (uni- axial), or coronal and frontal plain (bi-axial) or coronal, frontal and transverse plain (tri-axial). This mechanical kinesiological arrangement provides greatest number of clinical management options and prompted original question regarding combination/addition of various prosthetics components.
Sixth respondent Ms. Liz Backus (PDAC) acknowledged during two phone occasions that CMS has not at any time for any reason dis-allowed additional 5984 coding with base coding 5979 but has not provided email confirmation as requested and agreed to on both occasions. Rather, additional CSM information resource has been provided and I will forward PDAC site to anyone interested.
As another respondent noted, clear as mud. From a clinical perspective, respondent's coding comments regarding possible effect on interfacing made most sense. Respondent moved discussion from can we to should we and I think that's something we can all appreciate.
Michael Wilson LP/CPO
> ---------- Original Message ----------
> From: <Email Address Redacted>
> To: <Email Address Redacted> < <Email Address Redacted> >
> Date: 03/28/2022 2:01 PM
> Subject: Coding
>
>
> Good afternoon list served,
>
> Can anyone comment on clinical/administrative appropriateness of combing L5984 (transverse torque) with L5979 (dynamic response) super-structuring components? An explanation of how, why and when would be greatly appreciated.
>
> Michael Wilson, LP/CPO member AAOP
> Wilson Prosthetics Clinic
>
Five prosthetics clinicians responded to below question. Two suggested additional L5984 not applicable to base 5979, two suggested otherwise and one suggested applicability is entirely dependent of clinical evaluation, more specifically how might pressure/energy absorption/transfer rate effect mechanical/physiological interfacing. Withholding my own opinion, I would like to comment on combination plausibility from historical perspective.
USMC commercialized Star transverse torque absorbers in mid 60's and as one respondent noted incorporated at either end of pylon. Design included vertical mechanical axis twisting inside co-axial elastic coupling sleeve with dedicated coding 5984. In 1979, I was issued patent # 4,134,159 describing same twisting mechanism proximal housing monolithically incorporated into thermoset sockets; dedicated coding 5986 (Patent was assigned to Medical Center Prosthetics, Houston Tx. thus coding nomenclature MCP or equal). Both 5984 and 5986 facilitate transverse motion around a vertical mechanical axis, provide 10 or more deg. of rotation and functions independently of ankle dorsi/plantar flexion and pronation/supination. Appearance of 5979 coding (All LLP DR prosthetics, one piece, multi-axial) coincides with but not dedicated to College Park original dynamic (DR) response foot (phone conversation with College Park 4/4/22). Among other factitious mechanical kinesiological features,, transverse motion occurs in concert with ankle inversion/eversion or frontal plain motion. Incidentally, Merriam-Webster defines multi as many, multiple, much, more than two, more than one.
In 1994, Mark Smith CP (Ret. Knit-Rite) and I conferred with Medicare additional and dedicated coding 5975 combing uni-axial ankle with base coding 5972 (elastic keel) and additional coding 5984 with elastic keel provided tibial torsion be managed independently of ankle coronal/frontal motion. More recently I patented and commercialized DR articulated/elastic keel feet facilitating motion in coronal plain (uni- axial), or coronal and frontal plain (bi-axial) or coronal, frontal and transverse plain (tri-axial). This mechanical kinesiological arrangement provides greatest number of clinical management options and prompted original question regarding combination/addition of various prosthetics components.
Sixth respondent Ms. Liz Backus (PDAC) acknowledged during two phone occasions that CMS has not at any time for any reason dis-allowed additional 5984 coding with base coding 5979 but has not provided email confirmation as requested and agreed to on both occasions. Rather, additional CSM information resource has been provided and I will forward PDAC site to anyone interested.
As another respondent noted, clear as mud. From a clinical perspective, respondent's coding comments regarding possible effect on interfacing made most sense. Respondent moved discussion from can we to should we and I think that's something we can all appreciate.
Michael Wilson LP/CPO
> ---------- Original Message ----------
> From: <Email Address Redacted>
> To: <Email Address Redacted> < <Email Address Redacted> >
> Date: 03/28/2022 2:01 PM
> Subject: Coding
>
>
> Good afternoon list served,
>
> Can anyone comment on clinical/administrative appropriateness of combing L5984 (transverse torque) with L5979 (dynamic response) super-structuring components? An explanation of how, why and when would be greatly appreciated.
>
> Michael Wilson, LP/CPO member AAOP
> Wilson Prosthetics Clinic
>
Citation
Michael thomas Wilson, “Fwd: Coding,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 21, 2024, https://library.drfop.org/items/show/255862.
