AOPA urges CMS to make payments only to qualified O&P professionals | Study finds little evidence supporting helmets for flattened skulls | AOPA president questions plagiocephaly study
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May 6, 2014
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AOPA In Advance SmartBrief
News for Professionals in the Orthotics, Prosthetics and Pedorthics Profession

Top Story
AOPA urges CMS to make payments only to qualified O&P professionals
A recently released statement from AOPA expressed the association’s desire to continue working with the CMS to fight Medicare fraud in the O&P profession. The statement urged the CMS to ensure that Medicare payments for custom orthoses and prostheses go only to qualified practitioners and suppliers, thereby preventing fraud before it starts. “We hope to continue to improve the quality of care we deliver to patients who need orthotics and prosthetics, and to protect the integrity of the Medicare program,” the AOPA statement said. Healio (free registration) (5/2)
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Science and Technology
Study finds little evidence supporting helmets for flattened skulls
Using custom-made helmets to correct skull deformation in babies with plagiocephaly yields no better results than not treating the condition, according to a study published in the British Medical Journal of 84 babies with moderate deformities. The study did not rule out the benefit of helmets for children with more severe skull flattening or who have tight neck muscles. Custom helmet manufacturers, including Cranial Technologies and Orthomerica, questioned the results, and AOPA Vice President James Campbell said, “The value of this research is fully reliant upon the quality of the fit.” The New York Times (tiered subscription model)/Well blog (5/1)
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AOPA president questions plagiocephaly study
The British Medical Journal study about the use of cranial helmets did not address the appropriateness of their use for babies with more severe deformities, wrote AOPA President Anita Liberman-Lampear in this New York Times letter to the editor. She cited the narrow group of patients who took part in the randomized clinical trial and the high incidence of basic fitting problems as serious flaws with the study. “One cannot expect a device which shows many signs of possibly having been fit improperly to yield optimal results,” she wrote. The New York Times (tiered subscription model) (5/5)
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British scientist wins grant to study sensory skin for prosthetics
A researcher at the University of Glasgow has received a grant of about $1.8 million to develop a flexible tactile skin that could have wide application for use in robotics and prosthetic limbs. Ravinder Dahiya, senior lecturer in electronic and nanoscale engineering, has been able to integrate tiny electronics and sensors into silicon material thinner than aluminum foil that could be sensitive to touch and temperature but manufactured at low cost. The Economic Times (India) (5/3)
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Double amputee travels to Germany for bone-implanted prostheses
After experiencing increasing pain and difficulty putting on his prosthetic legs, bilateral amputee Bud Bailey, 72, traveled from his home in Michigan to the Sana Clinics in Lubeck, Germany, for osseointegration surgery that implanted threaded titanium posts into his thigh bones. He can then attach his prostheses to the posts. The procedure is not FDA-approved in the U.S., where it is still considered experimental, although the University of Utah is conducting a clinical trial. MLive.com (Michigan) (free registration) (5/4)
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Medical News
Innovations could help detect and treat diabetes
A new stick-on foot pad, available through some diabetes specialists in the U.K., can detect sweat to determine whether a diabetes patient is experiencing peripheral diabetic neuropathy that can lead to amputation. Another innovation is an implantable sachet developed by U.S.-based ViaCyte that slowly releases embryonic stem cells engineered to produce insulin. The treatment has been tested on mice, and human trials may begin within the next two years, according to this article. The Daily Mail (London) (5/5)
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Significant increase seen in diabetes rates among youths
The prevalence of type 1 diabetes among children and adolescents grew 21% from 2001 to 2009, while type 2 diabetes rates increased 30.5%, a study says. Researchers found that the increases in both forms of diabetes affected boys and girls across all racial and ethnic groups. The results were presented at the Pediatric Academic Societies meeting and appear in the Journal of the American Medical Association. USA Today (5/3), HealthDay News (5/3)
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Legislative and Regulatory
Accurate use of modifiers in claims is essential to timely approval
Including appropriate modifiers – directional, informational and functional -- when submitting a claim is essential to its approval, writes Devon Bernard, AOPA's assistant director of coding reimbursement, programming and education, in this article that explains the appropriate use of each code. For example, the GA informational modifier is used only when you expect the payer to deny the claim and the patient has agreed to assume financial responsibility if the claim is denied. The GZ informational modifier applies when you expect the claim to be denied and the patient has not agreed to assume liability. Functional level modifiers must be used with prosthetic feet, ankles and knees; if they are missing, the claim will be denied as not medically necessary. O&P Almanac (Adobe Flash required) (5/2014)
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Trend Watch
Army amputee rejoins paratroopers
When Army paratrooper Joshua Pitcher had his leg amputated below the knee after encountering an explosive device in Afghanistan, he endured depression and a dependence on painkillers on the road to recovery. Pitcher undertook a rigorous physical training regime that included jumping from an airplane with his titanium, blade-foot prosthesis, and he is now back serving with the 82nd Airborne in Afghanistan. The Washington Post (tiered subscription model) (5/1)
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After elective amputation, young woman gains active life
After 11 surgeries that only made her condition worse, Lacey Phipps ordered doctors to amputate her clubfeet in July 2012. Working with Leesburg, Va., prosthetist John Hattingh, Phipps, 23, now uses two prostheses and has been able to go rock climbing, play soccer and join in Irish dancing. Although casting methods to reposition clubfeet are commonly used in the U.S., doctors in rural Ireland, where Phipps grew up, instead chose to operate, and the many operations left her without bones in her ankles. Elective amputation is now considered a viable choice for many kinds of traumatic leg injuries and birth defects, according to this article. The Washington Post (tiered subscription model) (5/5)
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AOPA News
Breaking news from AOPA
AOPA 2014 National Assembly registration is open. Register today and get your hotel reservations --we’ll see you in Vegas! DME MACs have confirmed the delay of ICD-10 codes implementation -- get the scoop here! AOPA’s next Coding & Billing Seminar is in Boston, Mass. Get your lineup of practitioners and office staff ready to hit the proverbial home run with advanced coding and billing techniques -- it’s out of the park! OPAF adds First Swim staff and Scheck and Siress acquires American Limb & Orthotic Center -- all of this and more in today’s AOPA Breaking News.
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Upcoming events
May 14:  Modifiers: How & When to Use Them (Telephone audio conference) Learn more or register online.
June 12-13: Mastering Medicare: Coding & Billing Seminar, Boston, Mass. Learn more or register online.
Sept. 4-7: AOPA 2014 National Assembly, Las Vegas, Nev. Learn more.
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SmartQuote
We can often endure an extra pound of pain far more easily than we can suffer the withdrawal of an ounce of accustomed pleasure."
-- Sydney Harris,
American journalist
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