I have received a few more replies to my “Miami j versus Aspen” question:
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We’ve had some doctors order them for their patients and then have to change
them into Aspen Collars. The Miami J collar tends to cause too much pressure
on the sternum. Ask your Aspen dealer for the independent study that was done
on the collars. It shows that the Miami doesn’t hold as well, with flexion,
extension.
We use L-codes L-0172
Hope this helps.
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I have had extensive experience with both the Miami J and the Aspen collar;
in my experience, the Miami J is far superior in every aspect.
Specifically, and of most interest to your physicians, is the relative
position of the occiput vs. mandible pieces, and the allowance the different
sizing options of the Miami J provides for different body types (i.e.,
kyphotic patients, etc.) I work in conjunction with a very large Spine
Center, and a number of very well-known neurosurgeons, and they greatly
prefer (and insist upon) Miami J’s. My recommendation for coding would be
L0174 – I find it’s most appropriate. In response to your question about
the extra pads, I use a misc spinal code of L1499, and have had few problems
with reimbursements.
The other thing you may or may not be aware of is that Jerome Medical also
makes a thoracic extension for the Miami J, that clips right on to the
collar, essentially making it appropriate for high-level thoracic and
low-level cervical indications, much as you would use a SOMI or Minerva.
(Called the Miami JTO).
Best of luck. If you have any other questions, I’d be happy to answer them
for you.
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The Miami J is a great collar. A bit more substantial than the Aspens, but
still comfortable (tolerable) for the patient. I have used literally
thousands of them over the years in pre-op fittings for ACDF’s and even had
to wear one myself for six weeks after I had to undergo this procedure for a
C-5 level fusion. If the doc likes them too, you can’t lose. I would bill a
nominal fee for the extra pads.
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Many of the neursurgeons in the Charleston area prefer the Miami J collar so
we fit a lot of them. We used the Aspen for a while for a surgeon who left.
They appear to provide support but we have no scientific evidence. Try one
on. The Aspen wraps around for better circumferential constraint.
We use L0172 and L0984 for liner for the hospital billing. The liner code may
not be accurate enough for some 3rd party payers. It’s been hard to get paid
for the liners by some insurance companies so we usually charge the patient
and file for reimbursement
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Again, Thanks to all that responded.
Troy Fink, CO
