My Esteemed Colleague,
Interesting information I received today – We received a denial from Blue
Cross Blue Shield on a Transfemoral patient for which we applied for
pre-authorization for a prosthetic treatment with MPK knee and the reason
was that the patient had not been assessed using the PAVET Test. Keep in
mind that the patient was assessed using the Amputee Mobility Predictor and
scored a K3 Level activity.
After some research I found that the PAVET Test is the property of The
Hanger Group and I quote:
“PAVET™ is patent pending, copyrighted and the property of Hanger Orthopedic
Group, Inc
Evaluation Form and PAVET™ is licensed to Health Care Service Corporation
under License Agreement.
Blue Cross Blue Shield of Illinois is a Division of Health Care Service
Corporation,, a Mutual Legal Reserve Company,
An Independent Licensee of the Blue Cross and Blue Shield Association”
Therefore the following question – as it seems that the BCBS requirement for
an MKP Knee to determine functional level etc is now the pavet test and it
is the property of the Hanger Group Inc, will that disqualify all of our
patients as we are not licensed to use this test? When did Hanger and BCBS
get into bed btw? I missed that memo.
Thanks awfully,
John Hattingh CP
