Thanks to those of you who responded to my request. The answer is that that Region C has or had a “Service Specific Probe and Universal Review” in place. In the Spring ’04 Advisory, which hit my desk today, they published the results for “paid dates” 10/01/03 – 12/31/03.
These people have a real problem. In a two month period they had FOUR HUNDRED, SEVENTY-FOUR claims for L6550, yep, 474 shoulder disarticulation prostheses!
My problem is that they had to resort to a probe and universal review to figure out what was wrong with that picture. Medicare is thirty eight years old and they need a probe. Give me a Break!
I would encourage everyone in Region C to let their Congressman know if they feel even slightly abused by the system. And for those of you who are members of AOPA, you might ask why they (AOPA) haven’t been screaming about this as well.
Jim Fenton, LPO
