Getting answers to our billing questions always seems like “pulling hens
teeth” (they don’t have teeth). As an owner/practitioner it is a thorn in
my side that I deal with daily and expect it to get easier, which it is,
slowly but surely. The info is out there, but finding it can be daunting.
The answers Jim listed in his second post, are right; but I wanted to see it
in writing to feel we had a concise answer, so I pulled out my AOPA billing
and coding seminar manual (2007). I also just check the NGS web site (region
B) for LCD updates and there is one effective Oct 09, but the pertinent info
is the same.
There, in the LCD for Therapeutic Shoes for Persons with Diabetes (L11535)
it states:
“The Certifying Physician provides the medical care for and manages the
beneficiary’s systemic diabetic condition. The certifying physician must be
an M.D. or D.O. and may not be a podiatrist, physician assistant, nurse
practitioner, or clinical nurse specialist. The certifying physician may not
furnish the footwear unless he/she practices in a defined rural area or a
defined health professional shortage area.
The Prescribing Physician actually writes the order for the therapeutic
shoe, modifications and inserts. The prescribing physician may be a
podiatrist, M.D., D. O., physician assistant, nurse practitioners, or
clinical nurse specialist. The prescribing physician can be the supplier
(i.e., the one who furnishes the footwear).”
Craig R. DeCamp
Board Certified Orthotist & Prosthetist
craig@mobilelimbandbrace.com
—–Original Message—–
From: Orthotics and Prosthetics List [mailto:OANDP-L@LISTS.UFL.EDU] On
Behalf Of Jim Thelen
Sent: Monday, August 17, 2009 9:06 AM
To: OANDP-L@LISTS.UFL.EDU
Subject: [OANDP-L] Nurse Practitioner results (continued)
9. yes. should patient be medicare, you can not accept certifying
physician
statement for diabetic shoes from ARNP, otherwise, you good to go
10. My sheet from medicare says it must be an M.D. I don’t think there is
much discussion on the subject. Since all CNP’s are working under an
M.D. it would seem that that doctor would be required to sign the
sheet. That is just my opinion on the subject.
11. She can prescribe the shoes, but the Therapeutic Shoe statement must be
signed by an MD or DO who is responsible for the overall care of the
patient’s diabetes.
12. According to the rules, it must be signed by the supervising MD or DO
only.
Comment:
Clearly most people feel that it must be a MD or DO. But isn’t the
Therapeutic Shoe Statement a CMN? Wouldn’t the same rules apply? Maybe
someone has the printed rule as it applies to the Therapeutic Shoe
Statement.
—
Jim Thelen, LPO
Trinidad Medical Consultants
jimth@trinidadmedical.com
214-340-6200
