Dx. Specific DME Dx. Specific DME Protocols Protocols MPMA Summer Meeting MPMA Summer Meeting Hal Ornstein, DPM, FACFAS Hal Ornstein, DPM, FACFAS Chairman, AAPPM Chairman, AAPPM 18 Years in Private Practice 18 Years in Private Practice President of the President of the Jeff Frederick Fan Club Jeff Frederick Fan Club
Dx. Specific DME Protocols MPMA Summer Meeting. Hal Ornstein, DPM, FACFAS Chairman, AAPPM 18 Years in Private Practice President of the Jeff Frederick Fan Club. REASONS TO FOLLOW THESE PROTOCOLS. Improved outcomes Easy to follow Medico-legal security Improved patient compliance - PowerPoint PPT Presentation
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Dx. Specific DME Dx. Specific DME ProtocolsProtocols
Chairman, AAPPMChairman, AAPPM18 Years in Private Practice18 Years in Private Practice
President of the President of the Jeff Frederick Fan ClubJeff Frederick Fan Club
REASONS TO REASONS TO FOLLOW THESE FOLLOW THESE
PROTOCOLSPROTOCOLS• Improved outcomes• Easy to follow• Medico-legal security• Improved patient compliance• Improved patient satisfaction• Patient convenience• Ease of inventorying• Consistent with standards of care
DME Codes DME Codes L2999L2999 Non coveredNon covered L1902L1902 AFO gauntlet styleAFO gauntlet style L1906L1906 AFO multiligamentousAFO multiligamentous L4386L4386 AFO non-pneumatic walkingAFO non-pneumatic walking L4396L4396 AFO plantar fascia night AFO plantar fascia night
splintsplint L4360L4360 AFO pneumatic below kneeAFO pneumatic below knee L1971L1971 AFO with ankle jointAFO with ankle joint L4350L4350 AFO ankle control orthosisAFO ankle control orthosis L1932L1932 AFO dynamicAFO dynamic L1951L1951 AFO spiral, plastic, otherAFO spiral, plastic, other
727.68727.68 Rupture, tendon of foot and ankle, non-Rupture, tendon of foot and ankle, non- traumatictraumatic 728.4728.4 Laxity of ligamentLaxity of ligament 734734 Flat foot, acquiredFlat foot, acquired
729.5729.5 Ankle pain and supportAnkle pain and support 719.07 719.07 Effusion of joint, ankle, footEffusion of joint, ankle, foot 845.02845.02 Sprain and strain of ankle and foot, calcaneofibularSprain and strain of ankle and foot, calcaneofibular 845.01845.01 Sprain and strain of ankle and foot, deltoid ligamentSprain and strain of ankle and foot, deltoid ligament 824.2824.2 Ankle fracture, lateral malleolus onlyAnkle fracture, lateral malleolus only 824.6824.6 Ankle fracture, trimalleolarAnkle fracture, trimalleolar
729.5729.5 Ankle pain and supportAnkle pain and support 719.07 719.07 Unspecified disorder of ankle and footUnspecified disorder of ankle and foot 845.02845.02 Sprain and strain of ankle and foot, calcaneofibularSprain and strain of ankle and foot, calcaneofibular 845.01845.01 Sprain and strain of ankle and foot, deltoid ligamentSprain and strain of ankle and foot, deltoid ligament 824.2824.2 Ankle fracture, lateral malleolus onlyAnkle fracture, lateral malleolus only 824.6824.6 Ankle fracture, trimalleolarAnkle fracture, trimalleolar
736.79736.79 Acquired deformity of foot and ankleAcquired deformity of foot and ankle 438.20 438.20 HemiplegiaHemiplegia 719.97719.97 Joint derangement, ankle and footJoint derangement, ankle and foot 356.1356.1 Peroneal muscle atrophy, Charcot Marie Tooth Peroneal muscle atrophy, Charcot Marie Tooth
diseasedisease 340340 Multiple sclerosisMultiple sclerosis 138138 Poliomyelitis, late effectsPoliomyelitis, late effects 728.85728.85 Spasm of muscleSpasm of muscle
Flaccid Drop FootFlaccid Drop Foot : : Initial VisitInitial Visit
Ossur Equalizer Low Top WalkerSuggested Code: L4386DMEPOS Fee Ceiling: $171
Darco Med-Surg WalkerSuggested Code: L2999DMEPOS Fee Ceiling: Patient pays
Metatarsal FractureMetatarsal Fracture: : Follow up visitFollow up visit
PowerStep readymade orthotic
Suggested Code: L2999DMEPOS Fee Ceiling: Patient pays
Charcot, ActiveCharcot, Active
713.5713.5 Arthoropathy associated with Arthoropathy associated with neurological disorderneurological disorder
715.17 715.17 Osteoarthritis, localized foot and ankleOsteoarthritis, localized foot and ankle
Charcot, Charcot, Active,Active,
Goals of Goals of TreatmentTreatment
Prevent further deformityPrevent further deformity Obtain a plantargrade footObtain a plantargrade foot Avoid excess pressure on skinAvoid excess pressure on skin
715.17 715.17 Osteoarthritis, localized foot and ankleOsteoarthritis, localized foot and ankle 735.9735.9 Unspecified deformity of ankle and Unspecified deformity of ankle and
Disclaimer:Disclaimer:Suggested codes are based on publically available information and are offered as a convenience to physicians. The authors make no claims, promises or guarantees as to the availability of reimbursement for any of the suggested products. It is within the sole discretion of the physicians to determine the appropriate billing code for a product as well as whether the use of a product complies with medical necessity and other documentation requirements of the payor. The authors and the American Academy of Podiatric Practice Management accept no responsibility whatsoever in this regard.