Fellow Subscribers:
I saw a patient today I would like your help with. The patient is a 39 yo
male, with Spina Bifida. He is on Medicare/Medicaid. He ambulates w/o
assitive device. He has had triple arthrodeses bilaterally. The right has
broken down and the ankle rolls into severe varus, he has a tight heel cord
as well. The fifth ray and toe has been amputated, and severe callous on the
sole of his cavus foot.
Simple enough… Plastic AFO, solid ankle, with lateral extension and pull
stap, custom depth inlay for the Left (cavus) foot. Extra depth shoes.
Previous providers have fit him with high top custom molded shoes.
{Medicare/caid has paid via “creative coding” in the past.} He has no
additional resources. The only way the shoes could ethically be funded would
be to attach the AFO to the shoe. I have always considered how this could be
accomplished, knowing some day a patient would request it for this exact
reason. I have an idea, but would love to hear from the list.
Thank You
Gary A. Lamb C.O.
Certified Orthotist
Abilene, Texas
USA
http://www.oandp.com/pos
