Medicare Lower Limb Prostheses Proposed Local Coverage Determination

The profession is buzzing with talk of the proposed Medicare Lower Limb Prostheses (LLP) Local Coverage Determination (LCD). The last time Medicare moved to change this LCD (nearly ten years ago), the negative feedback from the O&P profession and the beneficiary community forced them to retire the adaptations. Medicare’s most recent draft revision of the LCD shows fewer and more targeted changes. How will these changes impact beneficiaries and O&P clinicians?

The proposed changes are a direct result of an LCD Reconsideration Ottobock submitted to the Durable Medical Equipment Medicare Administrative Contractors (DME MACs). An LCD Reconsideration is a formal process anyone can initiate to request a change to a Medicare LCD. However, CMS strongly recommends that any requested change submitted through the formal LCD Reconsideration process be supported by credible research, clinical trials, and/or published medical journals. (Ottobock’s LCD Reconsideration request can be viewed in its entirety on the CMS website within their Medicare Coverage Database as an attachment to the proposed LLP LCD.)