This information is inaccurate.
*Lesleigh Sisson, CFom*
702-400-1661
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On Wed, Apr 14, 2021 at 2:09 PM Waldner, Glen E < [email protected]> wrote:
> Had the same scenario in clinical practice. I explained to them that my
> license and certification was more important than billing for a prosthesis
> in a SNF and that they should consider their license more important also.
> The “other” facility that was providing service and ignoring the 2 day
> rule was eventually busted by the feds. One loop hole that is available is
> for the facility to discharge the patient and readmit after delivery of the
> prosthesis. Of course this takes some work on the facility but it does
> make it legal.
>
> Glen Waldner, LPO, CPO
>
>
>
> From: Orthotics and Prosthetics List
> Elizabeth Roof
> Sent: Wednesday, April 14, 2021 1:07 PM
> To: [email protected]
> Subject: [EXTERNAL] [OANDP-L] OPINION- DELIVERING A CUSTOM PROSTHETIC TO A
> SNF PATIENT
>
> **** External Email – Use Caution ****
>
> Our office was referred by an orthopedic surgeon to fit a new amputee with
> a prosthesis and we have been working with the SNF facility that the
> patient is in currently to do so. It has come down to delivering out the
> item and we notified the facility that we are unable to deliver a
> prosthesis to a patient in a part A stay in a SNF bed and the facility is
> responsible for the cost of the item. We told them that we cannot give the
> patient the item until 2 days before he is discharged home and they don’t
> understand this. They want to be able to bill for therapy minutes on gait
> training and teaching him how to properly don/doff the prosthesis. The PT
> called the office today and stated that another local O&P facility in the
> area has delivered items out to them before for patients to complete
> therapy still in the SNF part A stay and she doesn’t understand why we
> don’t do the same. I’ve sent her all the items regarding proper Medicare
> billing practices for SNF stay patients on the Noridian Medicare Portal,
> but I am curious if any other facility has run into this same issue and
> what you’ve done to help educate other medical professionals on the billing
> guidelines we are to follow to stay compliant with Medicare. We of course
> want to continue to see the patient regarding his prosthesis as we have
> finished all fabrication, but also want to avoid improper billing
> procedures set forth by the payer.
>
> Any tips or advice would be greatly appreciated!
>
> Thanks in advance!
>
> Liz Roof,
> Billing Supervisor & Office Manager
> 15418 West Center Road
> Omaha, NE 68144
>
> Sent from Mail<
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