Friday, May 20, 2022

Fw: Re: [OANDP-L] USA billing – covered???

ADVANCED O & P

—– Original Message —–
From: “ADVANCED O & P”
To: “Ted Trower”
Sent: Wednesday, November 06, 2002 5:28 PM
Subject: Re: Re: [OANDP-L] USA billing – covered???

> I’m back!! I just now spoke to another gentleman @ Cigna Reg D
> Medicare(Patrick McCreary)–his first response was “why does a person need
a
> prosthesis if they are in an electric wheelchair/ or on the other hand,
why
> do they need an electric wheelchair if they can walk with a prosthsesis?”
He
> then talked to an RN that told him that Medicare will not “deny the
> prosthesis based on the fact that the patient has an electric wheelchair.”
> “He said that all of the medical criteria for each patient will be
> considered on a case by case basis”. Sounds like the government version of
> CYA. HELP!!!! Can anyone provide specific cases where they were denied
> payment for a prosthetic patient because they had an electric wheelchair?
> Please respond ASAP as we have 2 patients waiting for a response.
> Thanks in advance!!!
> —– Original Message —–
> From: “Ted Trower”
> To:
> Sent: Wednesday, November 06, 2002 12:39 PM
> Subject: Re: [OANDP-L] USA billing – covered???
>
>
> > At 07:51 AM 11/4/02 -0600, you wrote:
> > >The overwhelming response to my question concerning medicare coverage
> > >for prosthetic treatment when the patient has a medicare covered power
> > >wheel chair —— no! Medicare feels as though the power chair is
> > >indicative of a patient who has given-up the possibility of ambulation
> > >and no coverage is provided.
> > >
> > >Thanks to all who jogged my memory.
> > >
> > >Gordon Bass CPO
> >
> >
> > Does this rule apply equally to trans-tibial amputees? Or is it only
> > applicable to trans-femoral amputees?
> >
> >
> > Ted A. Trower C.P.O.
> > A-S-C Orthotics & Prosthetics
> > Jackson, Michigan, USA
> >
> > www.amputee.com
> >
> > ********************
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> >
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> > questions, send e-mail to the moderator
> > Paul E. Prusakowski,CPO at [email protected]
> >
> > OANDP-L is a forum for the discussion of topics
> > related to Orthotics and Prosthetics.
> >
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>

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