As part of the Continuing Resolution passed today by the U.S. Senate and House of Representatives and signed by the president, clinical notes from orthotists and prosthetists will now be considered part of patients’ medical records. This change permits O&P practitioners to determine medical necessity for orthotic and prosthetic devices when submitting claims to Medicare and has the potential to reduce the backlog of claims under audit by Centers for Medicare & Medicaid Services (CMS).
Prior to a CMS policy change in 2011, the medical notes of O&P practitioners were valid as part of the record. O&P organizations have fought to reverse that policy since that time.
The law now reads as follows:
SEC. 50402. Orthotist’s and Prosthetist’s Clinical Notes as Part of the Patient’s Medical Record.
13 Section 1834(h) of the Social Security Act (42 U.S.C. 1395m(h)) is amended by adding at the end the following new paragraph:
“(5) DOCUMENTATION CREATED BY ORTHOTISTS AND PROSTHETISTS. – For purposes of determining the reasonableness and medical necessity of orthotics and prosthetics, documentation created by an orthotist or prosthetist shall be considered part of the individual’s medical record to support documentation created by eligible professionals described in section 1848(k)(3)(B).”