Thursday, May 2, 2024

Polio/Post Polio Syndrome/Non-ambulatory/Ins Coverage

Schwelke, Eric

All:

As a f/u to my above post, I received this definition from a responder:
ambulation

a nursing outcome from the Nursing Outcomes Classification (NOC) defined as ability to walk from place to place independently with or without assistive device.
I would argue that a justification could be made that “ability to walk from place to place independently with or without assistive device” would include 1-2 steps if that is what it takes for the patient to utilize the bathroom or go from the kitchen table to the sink. Those steps can be dangerous and costly to all stakeholders without the orthosis,.

It seems to me that this is not clear, but a fuzzy aspect of the clinical eval and subject to interpretation by payers.

Would anyone care to comment further?

Eric

Eric Schwelke CPO LPO, Director
Kessler O & P Services
11 Microlab Road
Livingston, NJ 07039
Direct Tel: 917 337 7557
Office Tel: 973 863 4231
Direct Fax: 717 635 3920
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