I guess that the solution to any problems these days requires that the
solution be more time consuming and complex to the extent that only a lawyer
can figure it out.
I looked over the recent proposed-Lower Limb Prosthesis Electronic Clinical
Template proposal from CMS.
On page one it states:
A lower limb prosthesis is covered when the beneficiary:
1. Will reach or maintain a defined functional state within a
reasonable period of time: and
2. Is motivated to ambulate.
That is all that the Medicare Manual requires except there are reasonable
and necessary requirements in the form of LCD ( L11442, L27013, L11464,
L11453).
The above mentioned Draft policy contains 22 elements for the physician to
address in order to meet the 2 covered criteria as well as the 4 LCDs.
Sounds like typical bureaucracy where the answer is in the amount of paper
work you can pile on no matter the relevance. This is what the future is for
O&P, fill out a new form to request the old form to request the older form
and so on and so forth till you get lost in the paperwork. That gives the
bureaucrat a way to justify their useless non- productive jobs.
Sounds like Congress. Do more to accomplish less at everyone else’s expense.
Sorry but the more that comes out of Washington the less I enjoy my work.
Helping those who need our help has always been my goal.
Not helping those in Washington justify and keep their jobs.
David Hansford, CPO, FAAOP
