I had a patient return to our office after a revision to his amputation due
to a fall shortly after his original amputation. The patient came in and
said that the MD thought that he was ready for a prosthesis. I called the
MD to ask for a prescription for the preparatory prosthesis, and the MD
said that he was told that he cannot prescribe the prosthesis until the
patient has had a physical therapy evaluation and “parallel bar test” to
prove that he is a candidate to ambulate and that the prosthesis won’t just
end up in a closet somewhere. First of all, aren’t we part of the decision
making process to determine if the patient can ambulate (and I know that
Medicare is saying that we have no say so and that is the MD’s job, who is
now telling me that it is PT’s job). Second, did he not just send the
patient to my office saying that he is ready for a prosthesis?
BTW…The patient is 54 years old, 6’2″ tall and 220 lbs. He is a BKA. He
is able to transfer himself and lives alone. He is very independent. In
my opinion, he is a candidate for a prosthesis, he is all healed up now,
minimal edema, and he is motivated to ambulate.
As far as I can tell, Medicare only wants us to have all this paperwork
done in the event of an audit after we have billed for a prosthesis. How
will Medicare be able to police who has these done and who does not? If we
bill for a leg and did not know about this, is Medicare now going to
deny/recoup the claim. I know it has not stopped them in the past for
other “rules” they have created. I have searched and can find no such
test. He has PT later this week and I have asked him to have the PT call
me to discuss this.
My question is, has anyone out there heard of the “Parallel Bar Test”?
What is this test? Who performs it? Which insurances require it? When
was it listed as a requirement, because I cannot find it.
Please help with this confusion, and thanks again.
Rachel Hartsell, CPO, LPO
Spears P&O
Memphis, TN
