Thursday, March 28, 2024

Ultralight materials denial

ingvar

Good morning

I have just found that Medicare is blanket denying ultralight materials
on any of our patients. Per our insurance department, ultralight
material is denied for prostheses “up front” as medically not necessary
and we have to appeal every single instance.
We are in Region D, Western Coast states, from CA to AK.
Is this something AOPA is aware of, others are experiencing, or it’s
just us missing something in paperwork?
Personally, I turn in LMJs for every piece of componentry and design,
along with detailed Rx from a doctor.

Thank you

Igor Lesko, LPO

Pacific Medical P&O
Seattle

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