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CMS Announces Proposed Rule on O&P Qualified Providers

This morning, CMS released a proposed rule that would enact the long awaited provisions of Section 1834(h) of the Social Security Act, which “requires that no Medicare payment shall be made for an item of custom-fabricated orthotics or for an item of prosthetics unless furnished by a qualified practitioner and fabricated by a qualified practitioner […]

AOPA Submits Comments on AHRQ Systematic Review of Lower Limb Prostheses

On December 1, 2016 the Agency for Healthcare Research and Quality (AHRQ) announced that it was soliciting public comment on the key questions that would be used in its previously announced systematic review of clinical literature relative to lower limb prostheses.  Comments were to be submitted no later than 11:59 pm on December 20, 2016. […]

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CMS Announces Initial Implementation of Prior Authorization Program-No Prosthetic Codes Included

On December 19, 2016, the Centers for Medicare and Medicaid Services (CMS) announced the initial implementation of the Medicare prior authorization program that was authorized through the final rule published on December 30, 2015. As expected, CMS has chosen a cautious approach in implementing its prior authorization program.  The initial list of codes subject to […]

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2016 Coding Pro O&P's comprehensive guide to Medicare codes, reimbursement, and medical policies.