In the latest webcast from the National Association for the Advancement of Orthotics and Prosthetics (NAAOP), Peter Thomas, JD, general counsel, spoke about the year-old Upper Limb Prostheses-Correct Coding guidance, which was retired this week, calling it “a major victory.”
Thomas expands on the work conducted by O&P Alliance partners over the past year to oppose the coding guidance, including a discussion of the antiquated the existing code set for upper-limb prostheses and how it needs to be updated, which the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) acknowledged in a statement.
Another topic Thomas addressed was a proposal by the Centers for Medicare & Medicaid Services (CMS) to cover seat elevation in power wheelchairs for Medicare beneficiaries, which NAAOP and the O&P Alliance submitted comments supporting. The comments focused on the benefits of seat elevation for people with limb loss and limb difference, whether or not they use prostheses or custom orthoses.
The Alliance’s comments also sought expansion of seat-elevation coverage for the purpose of reaching objects in the home and improving one’s line of sight to perform or participate in mobility-related activities of daily living, which aligns with CMS’ coverage policy for mobility devices. Seat elevation has been considered a convenience item by the DME MACs for over twenty years, but the decision to allow coverage would assist beneficiaries with transfers from one surface to another.
A final decision on the seat elevation National Coverage Determination is expected in May 2023.
To watch the NAAOP update, visit its YouTube page.