Medical Necessity in Prosthetics and Orthotics: An Interdisciplinary Care Team Approach
Date and Time
Cost: Free
CE Contact Hours: CE Credit is pending for the American Board of Certification in Orthotics, Prosthetics & Pedorthics; Commission for Case Manager Certification; American Occupational Therapy Association; and various Physical Therapy State Boards.
Medical necessity reasoning for prosthetic and orthotic devices is required by public funding sources and often requested by commercial payors, yet many practitioners struggle with differentiating medical necessity from functional needs or desires and efficiently documenting that information to build an effective clinical note for prostheses and orthoses.
This session will help participants better understand medical necessity related to prosthetics and orthotics, how it fits into physical rehabilitation, what type of medical record information can inform medical necessity for an expected health outcome after the provision of the prosthesis or orthosis, and how to come together to effectively document that information for better patient care.
Objectives
Upon completion of this program, participants should be able to:
- Define the difference between medical necessity and functional needs or desires;
- Explain what type of medical record information can inform medical necessity for an expected health outcome after provision of the prosthesis or orthosis;
- Interpret a method for processing medical information so it can be applied to medical necessity-based reasoning for prosthetic and orthotic care; and
- Create deeper patient relationships by looking at the whole person and long-term outcomes.
Session Outline + Timed Agenda
- Introduction: 5 min
- Panel presentations: 30 min
- Interdisciplinary medical record review: 10 min
- Q/A: 15 min
Speakers
Jeff Heckman, DO, FAAPMR
Physiatrist and Assistant Professor at University of Washington
Dr. Jeffrey Heckman is a board-certified physiatrist and a University of Washington assistant professor in the Department of Rehabilitation Medicine and also the Director of the Regional Amputation Center at the VA Puget Sound Health Care System.
Andreas Kannenberg, MD, PhD
Executive Medical Director, Ottobock
Andreas Kannenberg, based in Austin, TX, US, is currently the Executive Medical Director North America at Otto Bock HealthCare LP, bringing experience from previous roles at Otto Bock HealthCare GmbH, Bauerfeind AG, PreCon GmbH &Co. KG and Fresenius AG.
Molly McCoy, L/CPO
Clinical Documentation Specialist, Hanger Clinic
Molly has more than 20 years of experience, having worked as a clinician, educator, and technical adviser in settings ranging from independent small practices to level one trauma hospitals, nursing and rehab centers, and pediatric outpatient specialty clinics.
Dave McGill, JD
VP, Market Access & Business Alignment, Ossur
David has extensive experience dealing with coding, regulatory, and reimbursement issues affecting the O&P industry. He has led successful efforts to obtain codes from Medicare for Össur’s PROPRIO FOOT and POWER KNEE.
Continuing Education Requirements:
Virtual Sessions: Learners are required to register. Those who attend are sent the credit claim form where they are asked to attest to attending the entire session and complete a course evaluation (and quiz where applicable). Attendees are then sent a certificate of course completion once all requirements have been met.