Sunday, May 19, 2024

Sparking discussion


I sent this to the highest contact that I know within Region C. I would like to see if the industry feels it is worthy of being passed along to their contacts as well. Use it as you see fit.

The more audits that I face regarding knee braces the more it is clear that there is a misunderstanding within the LCD. I have spoken to many of my physicians regarding the LCD asking for “a physical examination showing instability of the knee”. We have also discussed the testing protocols that are listed, such as a “drawer test”. The OA knee does not ever present like a sports related injury. It does not become lax in the sense of ligament instability. The mild to moderate phases are best characterized by reduced motion, inflammation, and pain. The best option at this stage is weight loss and exercise, but at this stage the patient can no longer load the knee in stance phase without pain and increased inflammation. This is the role of an unloader knee brace to increase the stance time at this stage to allow for a rehabilitative lifestyle to be practiced. The understanding of the degenerative nature of the disease stands contrary to the LCD.

The audits are no longer based upon clinical practice or even the physician’s experience and expertise. They are based on keywords by people that do not understand the disease or the patient population that presents with this chronic illness. I am curious if there is a way to distribute this short video throughout the “auditing field”. I am hopeful that it will spark discussion.

Carey Jinright, LO, MSM
Be an example, not an excuse!


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