The New Reality: Documenting O&P Medicare Claims
By Peter W. Thomas, JD, and Christina A. Hughes, JD, MPH
The August 2011 "Dear Physician" letter sent to all physiciansparticipating in the Medicare program and theU.S. Department of Health & Human Services (HHS)Office of Inspector General (OIG) report that preceded it-"Questionable Billing by Suppliers...
Medicare Audits, Overpayments, and Appeals
By Peter W. Thomas, JD, and Christina A. Hughes, JD, MPH
Over the past few months, there has been increased activitywithin the federal government surrounding Medicareaudits, overpayments, and appeals. This articlesummarizes two major developments that will impact all Medicareproviders, including O&P pro...
Outcome Measures: Are We There Yet?
By Kate Hawthorne
How do you measure the quality of the prosthetic or orthotic devices you provide to your patients? Many practitioners say a successful outcome is a happy, comfortablepatient who returns to you when it's time for a new fitting. In today's reimburse...
Walk This Way: Gait Assessment Technology Steps Forward
By Garrison Wells
The usual purpose of lower-limb orthoses and prosthesesis to enable or improve the wearer's gait. How well thedevice achieves this goal has historically been judged subjectivelyby the patient and clinician. "Nevertheless," says Joan E.
The Dawn of Powered Lower-Limb Prostheses
By Phil Stevens, MEd, CPO, FAAOP
During the last decade, the O&P industry has enjoyed a technological renaissance. As technologies improve and become more reliable, their adoption becomes more widespread. For example, the microprocessor regulation of prosthetic knees, once a nove...
Implementing EMR in P&O
By John Brinkmann, MA, CPO, LPO, FAAOP
The Digital Revolution The British computer scientist who is credited with inventingthe World Wide Web, Sir Timothy "Tim" Berners-Lee, made asurprise appearance at the end of a dance segment during theLondon 2012 Olympic Games opening ceremony. Th...
Prosthetic Liners and Sleeves: Reaching New Levels of Comfort, Control, and Suspension
By Miki Fairley
Photograph courtesy of Ottobock. The issues that challenge prosthetic liner and sleeve manufacturersare age-old: durability, residual-limb volumefluctuations, temperature and moisture control, and skinhealth. The solutions that are in development,...
New Faces in O&P Leadership
A conversation with Kenneth Wilson. In the second installment of our interview series with two companychiefs who are relative newcomers to O&P, The O&P EDGE talksvision and goals with Kenneth Wilson, president and chief operatingofficer of SPS, he...
T. Walley Williams III
By Miki Fairley
Williams employs his carpentry skills making balusters for a friend. Photographs courtesy of T. Walley Williams III.
Stacey Pryor: New Leg Leads to New Career
By Linda M. Hellow
Pryor appreciates the ability to go from wearing work shoes to no shoes when she gets home from work. Photograph courtesy of Össur Media. Stacey Pryor of Denton, Texas, is the type of person who doesn'thesitate in new situations.
Pedorthics-Oriented Research (or the Lack Thereof)
By Dennis Janisse, CPed
There has been mounting pressure in recent years from third-partypayers-and consumers-for evidence that a device or procedureactually performs as claimed before considering paymentfor services. In fact, Section 6301 of the Patient Protection andAf...
Translating Skills: Using Past Experiences to Solve Challenges in the O&P Lab
By Robert Reeves, CTPO
While some technicians gravitate toward the O&P lab early in theirprofessional lives, others, like me, find themselves in the industryafter careers in a variety of other fields. I entered the O&Pprofession well into my adult life, and as I have pr...
Face to Face
Doug Jack, CPO
After completing an automotive technology program, DougJack, CPO, says that while he appreciated the technology andmechanical skills he had learned, he realized a career as anauto mechanic was not for him. While seeking alternativecareer options,...
Billing and Collections Q&A
By Lisa Lake-Salmon
Denials are difficult to identify and time-consuming to appeal. Count on "Got FAQs?" to help you sort through thecomplexities associated with O&P billing. This month's column addresses your questions about Medicare Change inProducts and Services,...
Many Stories, One Voice
By Karen Henry
If you've ever been to an American Orthotic &Prosthetic Association (AOPA) Policy Forum or anAmputee Coalition National Conference, you'veprobably learned how telling your story can helpto promote your advocacy efforts. Storytelling isa common rhe...
Standardizing Technology across Rehabilitation: Endolite echelon Stands out in Independent Study
EDGE Direct Endolite is setting the standard for rehabilitation with our revolutionary line of hydraulic ankle/feet systems. Our hydraulic ankles help to decrease energy expenditure, encourages equal loading and reduces pain, socket pressure, and...
Structured Light Scanner New to The OMEGA System
EDGE Direct Computer-assisted design (CAD) is here to stay in the orthotic and prosthetic (O&P) industry. The time savings, successful patient outcomes, and cost savings have allowed what was once a fledgling technology to gain a growing foothold...
Educate Referral Sources about Your Clinic.
Regular, ongoing communication with your
referral sources is critical to growing your
business. Here are just a few ways that
EDGE Custom Publications can help:
- Brand your clinic and build your reputation.
- Tell readers about your company, your specialties, and your patient outcomes.
- Create ongoing marketing campaigns with your own referral-source-focused mailer.
- Customize a publication to suit your needs and patient populations.
- Include contact information, maps, directions to your location, clinical services provided, and provider networks.
EDGE Custom Publications
The Go AFO from Hersco is a rear-entry
ankle gauntlet designed for
patients who have difficulty donning
traditional braces. The gauntlet is a
traditional thermoplastic ankle foot
orthosis with a thin leather lining and
outer layer that secures posteriorly
using either a Velcro or lace closure.
Now Chopart, Lisfranc, or
transmetatarsal amputees who need
a partial-foot prosthesis (PFP) can
combine the Go AFO with a filler. The
Go AFO provides excellent support
and control for the remainder of the foot, and the PFP portion
can be fitted into regular extra-depth shoes.
Hersco Ortho Labs
At long last, Coyote Design has released a new catalog! It's been
an eventful year of changes, as we have been making a number
of improvements to our products. We have also been hard at
work on some new products that are already available and some
that will be out soon-all of which are in the new catalog. If
you would like to receive a catalog, visit our website and fill out
the online request form, or send your contact information to
The echelonVT merges the fluid movement of our hydraulic ankle with the responsive function of our e-carbon foot springs and machined titanium spring. This combination results in a smooth heel-to-toe transition on all surfaces, absorbs ground forces, and provides energetic tibial progression and up to 15° of axial rotation.
- Self-aligning feature provides comfort while standing or traversing varied terrain.
- Independent, hydraulic-controlled plantarflexion and dorsiflexion.
- Hydraulic ankle dorsiflexes, which allows for greater toe clearance in swing phase.
- A dynamic, precision-engineered spring enhances the ankle's fluid movement.
- Foot shell and glide sock included.
Give your patients the most advanced KAFO technology combined with the most advanced fabrication! Ottobock's line of KAFOs is now available in prepreg, resulting in KAFOs that are up to 40 percent lighter than laminated alternatives. Prepreg also creates more consistent fabrication outcomes and avoids unwanted buildups.
Ottobock Fabrication Services offers decades of expertise, exceptional customer service, and an unparalleled reputation for quality. Our expert services include water transfer, lamination, and prepreg carbon fiber. You can count on timely turnaround and delivering the results you want.
Spinal Technology is a leading
central fabricator of spinal orthoses
and upper- and lower-limb orthoses
and prostheses. Our ABC-certified
staff of orthotists and prosthetists
collaborate with highly skilled,
experienced technicians to provide
the highest quality products and
fastest delivery time, including
weekends and holidays, as well as
unparalleled customer support in the industry.
Spinal Technology is the exclusive manufacturer of the
Providence Scoliosis System, a nocturnal bracing system
designed to prevent the progression of scoliosis, and the
patented FlexFoam™ spinal orthosis.
The PreStride™ allows practitioners to make an informed decision regarding the suitability of Becker Stance Control Technology prior to manufacturing a definitive orthosis. Intended as an assessment tool for the FullStride™ and SafetyStride™ Stance Control Systems, the PreStride now also comes equipped with the GX-Assist. The GX-Assist accommodates individuals with significant weakness of hip musculature by use of a pneumatic spring to assist in knee extension during the swing phase of gait.
Ability Dynamics is a medical-device company created with a passion for helping amputees through the utilization of advanced technology.
Our state-of-the-art Rush Foot™ uses Flexeon™, a specially formulated, reinforced fiber-composite material that is nearly indestructible and three times more flexible than carbon fiber. This translates into fewer repairs, maintenance, and warranty claims.
Our full rocker sole is designed for the needs of above the knee amputees. The half rocker sole is designed for the needs of below the knee amputees. Visit us at www.facebook.com/rushfoot
The avalon foot provides 12° of controlled ankle motion, allowing the user to safely negotiate stairs, ramps, and environmental obstacles with increased confidence and security.
- Dorsiflexes from midstance to toe off for a smooth rollover.
- Remains dorsiflexed through swing phase for improved toe clearance, to minimize the risk of falls.
- Provides a more natural gait; reduces the need to compensate by hip hiking, circumduction, or lifting the knee to clear the toe during swing phase.
- Biomimetic ankle motion encourages equal loading during ambulation, which leads to less stress and thereby preserves the sound side.
Townsend Design has released the BOLD
off-the-shelf (OTS) ligament instability knee
brace, featuring Townsend's proprietary hinge
motion and suspension technology.
The BOLD's hybrid design combines a
rigid aluminum superstructure with semirigid
proximal and distal bands that conform
to the leg-optimizing the fit and functional
control provided by the brace. Incorporating
Townsend's patented anti-migration Synergistic
Suspension Strap that purchases on top of the
calf muscle, the BOLD stays properly positioned
on the leg during all types of physical
activity. Available in five sizes, the BOLD is an
economical choice for stock inventory.
Use Coyote Designs' new material, Coyote Composite. Made from basalt (volcanic rock), this material is inert, safe, and causes much less itch than carbon. This braiding is similar in weight to carbon, but is less rigid for a more flexible, comfortable socket layup. It also is tougher than carbon or fiberglass to withstand impact and resist delaminating, and it is less expensive. Available in 3-, 4-, 6-, 8-, and 10-inch braids, as well as reinforcement rope or sheet fabric. Now with an even lower price.
The best silicone liner for vacuum and expulsion socket systems.
Evolution Industries Inc.
The Stride4™ Shadow is a lightweight KAFO that combines structural strength and cosmetic appeal with the new Stride4 mechanical stance control orthotic knee joint from Becker Orthopedic.
Stride4 features include:
- Three operation modes: stance control, free motion, and locked with stance phase knee flexion.
- Four-bar linkage mechanism to afford stability and mimic anatomical knee motion.
- Integrated extension assist.
The inherent rigidity of the Stride4 Shadow ensures that optimal joint alignment and function is maintained throughout the gait cycle.
Comfort, security, and reliability! Now your patients have more
options to meet the demands of their active lifestyles. The Triton
Low Profile (LP) and the Triton Heavy Duty (HD) are especially
robust and waterproof, ready for the most challenging conditions.
Or, choose the lightweight Triton carbon fiber foot, the Triton
Vertical Shock (VS), or the Triton Harmony® with integrated
vacuum technology for outstanding flexibility and support.
With K2, K3, and K4 models to choose from, the Össur® Total Knee® enables a broad range of amputees to walk with a smooth, more natural, energy-efficient gait, enhancing their confidence and stability. Key features include geometric locking for stability, plus mid-swing shortening designed to prevent hip-hiking and reduce the chances of tripping. Each model fits a wide range of amputees and is lightweight and easy to finish cosmetically.
The OAK™ (Osteo-Arthritis Knee) Joint from
Fillauer LLC, for use in custom knee orthoses,
provides motion that better approximates normal
physiologic knee movement. Unlike simple pivot
knee joints, the polycentric action of the OAK
provides inherent stability at full extension and
easy gliding during swing phase, allowing the
patient to feel "glide-flex" stability during the first
5° of flexion. Flexion is dynamically adjustable with
extension stops to meet rehabilitative demands. It
is available with Comfil® thermoformable composite
materials, which can be custom fit with a heat gun
for increased comfort and support.
PEL Supply Company
The AIRPUCK™ system is a cost-effective
vacuum reservoir that can
maintain negative pressure within the
prosthetic socket for extended periods
of time (6-10 hours). The AIRPUCK
system completely seals the distal
aspect of the socket, allowing users to
open the valve and remove air in the
socket to achieve vacuum suspension.
The vacuum barb is neatly concealed
in the valve housing. Blister pull
fabrication makes an air-tight socket
a breeze. No hoses, barbs, or ports to contend with. The AIRPUCK
is a self-sealing, modular, drop-in vacuum component.
5280 PROSTHETICS LLC
Grace Prosthetic is proud to offer Gator Glass exclusively. This
patented illumination technology allows for custom designs
and graphics to be incorporated into prostheses. When turned
off, Gator Glass looks like a traditional surface emblem. When
switched on and lit up, Gator Glass designs glow with the color
and precision of a digital image.
Grace Prosthetic Fabrication
Available at SPS, the reliable, speedy, and versatile bebionic3
can be configured to handle almost anything your patient needs
to do. bebionic3 is designed to be stronger and more durable
so it can be worn daily and withstand the stresses and strains of
The Stride4™ is the latest addition to the Stride family of stance-control orthotic knee joints from Becker. The Stride4 knee joint is comprised of a four-bar linkage mechanism, whereby the upper and lower aspects of the joint do not purely rotate about one fixed center of rotation. Instead, the joint motion involves some translation, in addition to rotation, to more closely mimic anatomical knee motion.
- Three operation modes: stance control, free motion, and locked with stance phase knee flexion.
- Integrated extension assist.
- Free motion option.
The Perfect Balance
For users with less active lifestyles who are engaged in low-impact activities and walk at a constant speed, the Balance Knee by Össur® offers the perfect balance of safety, adjustability, and durability. Adjustable stance control balances stability and swing initiation, while mid-swing shortening increases toe clearance to help prevent hiphiking and reduce the chances of tripping. Plus, the Balance Knee is maintenance free, easy to align, and fully adjustable without disassembly.
Accommodate, NEVER correct! People with Charcot foot, edema, hammer toes, bunions, and RA foot pain cannot tolerate much correction or pressure caused by footwear. Proper fitting of footwear is essential, and our Mt. Emey therapeutic line offers shoes for any of these conditions. Whether accommodating for depth, width, size, or even for shape, select from our variety of shoes from our therapeutic line to fit that special foot of your patient. Call our friendly customer service department for more information or free samples.
Apis Footwear Co.
The Moore Balance Brace (MBB) is
a new product that may be used as
an integral part of a comprehensive
fall-prevention program. The MBB
was designed to be lightweight,
easy to don and doff, easily fit
into a variety of footwear, and
flexible enough to allow for some
the gait cycle.
Find out more about this exciting
new product and how it can be used
to help our ever-growing
Uncompromising Strength and Stability Made for Every Body.
Tested and approved for definitive use, Kinetic Revolutions Adjustable Pylons are trusted by practitioners for patients of all ages and activity levels; they are available in three sizes (standard, short, and pediatric).
Kinetic Revolutions Adjustable Pylons are milled from a single piece of aluminum and therefore are engineered to be stronger than conventional pylons. Cutting, grinding, and wasted pylon scraps are now a thing of the past.
The innovative cost-effective solution for optimal suspension in vacuum and expulsion systems.
Evolution Industries Inc.
PEL Supply offers the Camber Axis Hinge® from Becker Orthopedic, now available in three sizes. In addition to the existing medium and large sizes, the newest small size is for pediatric and other patients who weigh less than 90 pounds (40.5kg).
Features and benefits include:
- Adjustable range-of-motion ankle joint.
- Anatomical axis alignment for thermoplastic orthoses.
- Seven color-coded range-of-motion keys.
- Eliminates need for posterior stop mechanisms.
- Permits solid ankle design changes to articulated motion with variable stop settings.
- Three sizes-small, medium, and large.
- Optional black, noncorrosive finish.
PEL Supply Company
The Venture® combines College Park's trademark multiaxial design with a higher frequency dynamic response for more active users. The highly functional, custom gait-matched design includes CPI's exclusive Stride Control™ feature, providing quick and easy gait adjustment without disassembly.
Key features include:
- True multiaxial function with transverse rotation for natural-feeling performance.
- Extended toe lever facilitates immediate power and increased response with each stride.
- Adjustable Stride Control™ helps fine-tune gait without disassembly.
- Scaled design allows for more natural proportions.
- Same-day, custom built to order.
College Park is currently running a special on the Venture foot as part of its year-long 25th anniversary celebration.
College Park Industries
Expect 50+ mph fastballs and natural, instinctive throws with distances of more than 30 meters. Never in prosthetics has such performance been possible for restoring baseball throwing ability in an individual with an upper-limb amputation. Throw accurately with speed and control.
Bob Radocy says, "It's simply amazing! I'm able to throw well again after forty years. I never, ever thought that would be possible!"
The COBRA uses TRS' energy-storage-and-release polymer technology combined with an adjustable ball handling and trajectory control system to fine tune the throwing capability and optimize user performance.
The Genu Sleeve is a transtibial suspension sleeve that provides
the ultimate in comfort, suspension, and ease of use.
- Inner TPE gel surface provides optimal sealing and suspension.
- Longitudinal-knit cuff allows generous radial stretch for a secure and comfortable fit.
- Round-knit textile cover means no seams to unravel or irritate.
- Comfort zone knitting in patella and popliteal region for greater freedom of movement during knee flexion.
- Smooth outer textile slides easily against itself for simple donning.
- Includes free inner protector sleeve (also available separately).
- Can be used with the new medi Vacu-Valve with simple fabrication.
KiddieROCKER™ is the newest addition to Allard's pediatric
dynamic response AFOs. Developed for your pediatric population
with more involved pathology, the extra rigidity offers enhanced
balance and posture control, especially for weak quadriceps.
Features and benefits include:
- Carbon composite with anterior shell, lateral strut, and engineered footplate with open calcaneal design.
- Allows integration of your custom foot orthotic to help control ground-up forces.
- Lateral strut can serve as a base for a T-strap to control excessive ankle eversion.
- Anterior shell assists in management of proximal deficits by helping manage either knee hyperextension or crouch gait.
Orthomerica® Products is pleased to introduce the new Spectrum Slim™-now heat adjustable-a valuable addition to our Spectrum™ AFO product line. This slimmer and sleeker eye-catching gauntlet is designed to allow your patients a greater range of shoe options. The Spectrum Slim is ideal for patients who find standard gauntlets challenging to get into a shoe. Its low-profile design makes donning and doffing much easier for the patient, and its soft leather offers maximum comfort. The Spectrum Slim is available in black or tan leather or black or white synthetic material.
ABC is making all certification exams more readily available.
- All written and written simulation exams will be offered every other month.
- Clinical patient management exams will be offered three times a year.
- Practitioner candidates have 30 days after the application deadline to complete their residency requirements.
Visit the ABC website for more information on exam dates and application deadlines.
American Board for Certification/ABC
medi USA is proud to introduce
the SLEEQ® series of spinal bracing
solutions. The SLEEQ Spinal Therapy
System's InvisAdjust™ technology
enables a universal fit for nearly all
patients while dramatically reducing
the hassle and cost of unwanted
inventory. SLEEQ's state-of-the-art
TruGlide™ tightening makes it easy
to achieve optimal compression for the most effective pain
relief. The advanced eco-friendly Q-Lex™ OrthoSport Material
promotes air flow to keep patients cool and dry. The low-profile
ventilated AeroFlex™ support system automatically conforms
to the patient's anatomy for a custom fit, providing optimum
comfort and pain management or operative treatment support.
Delcam's easier-to-use OrthoMODEL 2013 has new developments specifically for accommodative orthotics, which will benefit practitioners and laboratories that support patients with diabetes and clients who need comfort insoles produced from EVA or similar softer materials. The orthotic can be created from the prescription as it is input. Sculpting, cuts, and additions, such as depressions for relief of ulcerated regions, can be added at any stage. With the new "real-time" design, the complete orthotic can be visualized and modified in real time so the practitioner or laboratory can approve the generated shape before it is sent for manufacturing.
The Swing Phase Lock 2 (SPL2) uses a
simple internal pendulum mechanism to
lock and unlock the knee depending on the
joint angle in the sagittal plane. During gait,
the device locks just prior to heel strike for
support during stance and unlocks the knee at
heel-off in preparation for swing, mimicking
the normal physiologic action of the knee
extensors. Because the mechanism is position
dependent, it does not rely on heel loading
or cabling as in other designs, allowing for
a more normal gait pattern and preventing
circumduction or hip hiking.
TRS and Boa Technology have
revised their previous kits
and introduced a new Boa
Technology O&P ToolKit. The
ToolKit has six reel selections
in both low and medium
power and a large assortment
of support components. Reel
options include eyestay and
tongue versions for greater versatility in creating one-off, singlehanded,
custom O&P solutions using high-performance Boa
technology. The O&P ToolKit, which is competitively priced for
value, includes a comprehensive instruction book that illustrates
the various reel options and their applications.
WillowWood's LimbLogic® VS has been a popular choice with clinicians to provide patients with elevated vacuum. Now WillowWood has made this popular product even better.
The new LimbLogic features a small, Bluetooth® Low Energy fob, inductive charging, and an improved four-hole controller design with a field-serviceable exhaust filter. The smaller, simplified fob is more intuitive to use and maintains the same functionality.
Join us for a webinar or an on-site education course to see
the new LimbLogic features that build upon field-proven
technology, making the system more robust and easier to use.
The practitioners who developed
Limbguard™ know the importance of
effective early care and the impact this
has on building a lasting relationship
with patients. Limbguard's unique
design considers volume management,
wound care, and knee range of motion.
The product line consists of four sizes
designed to fit both left and right
residuum. Limbguard is available from
Friddle's Orthopedic Appliances at
www.friddles.com. Visit Friddle's at the
Academy Meeting in Orlando at booth
The Regal Acrylic Stretch Prosthetic
Sock is a unique blend of acrylic and
Lycra, which provides a degree of stretch
and conformance to the residual limb
that is not possible with other fiber
combinations. It has great stretch yet
retains its shape for a superior fit. The
interior fleece increases the wicking
power and provides superior moisture
management compared to any sock
offered that is not fleeced. Available with a
3S hole, either knitted or vulcanized. Easy
to care for-just machine wash and dry!
Call to order your Regal Prosthetic Sock today!
Inland Central Fabrication Services
(ICFS) is located in Southern California.
Whether it's your overflow or all of your
company's fabrication needs, ICFS can
handle the job. We offer competitive pricing
and turnaround times. Our technicians-
who will stay with your job start to finish
to ensure quality-have more than 30 years
of combined experience in patient care
facilities, so they understand what your
patients deserve. There is always an open
line of communication between our staff and yours. When the
need arises, consider Inland Central Fabrication Services as
your C-fab facility.
Inland Central Fabrication
Practitioners who use offset plates can now do so with less added weight. Prosthetic Design Inc. introduces Carbon Fiber Offset Plates. The plates are available in three sizes: 1/2 in., 3/4 in., and 1.418 in. Offset in either AP or ML orientation for patients up to 325 lb. The Carbon Fiber Plates reduce weight by 40 percent compared to the equivalent aluminum versions. Contact Prosthetic Design Inc. for more information and recommended L-Codes.
Prosthetic Design Inc.
Accepting Applications Now!
Begin your P&O career at NUPOC! Learn from leaders in the P&O profession! The NUPOC MPO is a 21-month graduate curriculum that prepares you to enter an accredited residency, sit for certification examinations, and become a P&O practitioner.
The online portion of the program includes live and streamed lectures, videoconference discussions, group projects, and case-study sessions that help you learn, apply, and review knowledge. The on-campus practicum offers supervised opportunities to practice technical and clinical skills with patient models who have neuromuscular impairments.
Northwestern University Prosthetics-Orthotics Center
Feinberg School of Medicine