My question is regarding RAC audits and Medicare requiring more information
as well as future requirements for documentation. Is it time to push for
reimbursement for our extensive evaluations.
We are documenting muscle testing, ROM, doing quantifiable, written,
reproducible gait analysis and outcome measurements in a printable form.
That is shared with Physicians, PTs, OT and the rest of the medical
community.
Is it time that we, (at least the ones of us that are doing it), insist to
be recognized as clinicians instead of brace and limb makers and be paid for
our evaluations.
I know that I am not the only one that is up at 4:00am fulfilling our
compliance from the previous day.
I know my notes of 10 years ago were lacking and I could have been
considered a brace maker. But now I am definitely a clinician.
My ABC facility inspector 10 years ago told me that my notes were the
average in the industry at that time and inadequate.
I greatly improved but not near the level that I am now.
My evaluations now all include documented Muscle tests on both limbs, Range
of motion, electronic gait analysis, quantifiable and reproducible outcome
measures and much more.
This is an insult to be in the group of DME when our documentation is at the
very least equal to PT and in most cases exceeds theirs.
This is all necessitated by the unfair RAC audits.
The vehicle that guides me to this level of documentation is OPIE.
I can’t believe that as of now we can’t bill for this level of patient care.
We are all documenting to a level that has not been necessary in the past
but is now necessary as we are assumed to be frauds prior to providing
service.
What do you think?
Are we brace and limb makers or clinicians?
Should we be able to bill the payers that are necessitating this extra
diligence?
Mike Kiser, C.O.
Kiser’s Orthotic and Prosthetic Services, Inc.
www.kisersoandp.com
