Just making you aware. There is a large number of out of state suppliers contacting beneficiaries by phone concerning braces, then they fax a prescription in to the physician’s office, for the brace that was discussed with the patient.
There are two problems with their business plan.
* Phone solicitation to the patient. (violation of Medicare supplier standards)
* Mailing a brace into the patient negates the “fitting and adjustment” portion of the HCPCS code!
Many of these braces have resulted in poor fittings. Worse, I have seen many patients with diagnoses that clinically should be treated with the use of another type brace. An example, an Acute L-1 Fracture being treated with a soft LSO brace. Any spinal fracture above L-2 should be treated with a TLSO preferably rigid unless co-morbidities prevent rigidity.
These companies have gone from Spinal, knee, and now to AFOs. They are gaining ground. Just letting you know. It is companies such as these that will spark many more RAC and ZPIC audits in 2012. Please remember this email and others like them, and the silence from our industry leaders as we feel the squeeze from this improper approach to patient care!
Carey Jinright, LO, ATP, MSM
Cross & 3
