Orthotic reimbursement means knowing Medicare policy and standards | Mass. company introduces robotic arm orthosis | Advances in robotics lead to new generation of prostheses
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October 10, 2013
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News for Professionals in the Orthotics, Prosthetics and Pedorthics Profession

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Orthotic reimbursement means knowing Medicare policy and standards
CMS is using the lack of physician documentation to deny claims not only for lower-limb prostheses, but for orthoses as well, according to Joe McTernan, AOPA director of coding and reimbursement services. He summarizes the requirements for AFOS and KAFOs set forth in the Local Coverage Determination and Policy Article, noting that they must meet the definition of a brace under the Medicare Braces benefit category. O&P Almanac (Adobe Flash required) (10/2013)
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Mass. company introduces robotic arm orthosis
Myomo, which describes its robotic braces as "power steering for your arm," has released its newest version, the MyoPro, for patients with arm deficits caused by stroke, brain damage or multiple sclerosis. Sensors on Myomo's motorized braces boost nerve signals that trigger muscle movements, allowing the arm to move and flex. Next for the company is "a pediatric-sized device, to assist kids born with cerebral palsy," said CEO Paul Gudonis. Xconomy (10/9)
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Advances in robotics lead to new generation of prostheses
From microchips to brain-controlled prostheses, medical technology and robotics are merging to create a new generation of prosthetic devices. "In some discussions with the international standard-setting body for prosthetics, there is talk of no longer speaking of prosthetic arms but of wearable robotic devices," said Robert Jaeger, of the Veterans Health Administration Office of Research & Development. The author traces the long history of artificial limbs from archaeological finds to a listing of today's state-of-the-art advances. Military & Aerospace Electronics Online (10/8)
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Medical News
Scientists ID enzyme that impedes healing in diabetes-related wounds
Researchers working with diabetic mice found that the matrix metalloproteinase enzyme MMP-9 slowed wound healing. Inhibiting the action of the enzyme accelerated wound healing compared with placebo. The researchers will next test enzymes found in human wounds. Chemical & Engineering News (10/3)
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Diabetes complication risk drops after bariatric surgery
Data on more than 600 type 2 diabetes patients showed the rate of complications of the eyes, kidneys, peripheral nerves or peripheral circulation requiring admission was 20% in those who underwent bariatric surgery and 45% in the non-surgery arm after 20 years. Patients who underwent surgery also had a 77% lower risk of incident diabetes during the 20-year follow-up period compared with the controls, researchers reported at the European Association for the Study of Diabetes meeting. Clinical Endocrinology News (10/8)
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Legislative and Regulatory
House bill would allow trained school staff to care for students with diabetes
A bill before the House of Representatives would allow trained staff members who are not health professionals to administer insulin and provide other care to elementary- and high-school students with diabetes. Many schools can't afford a full-time nurse, according to Gina Gavlak of the American Diabetes Association. The bill would offer immunity from lawsuits to trained personnel. The Columbus Dispatch (Ohio) (10/10)
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Trend Watch
Growing senior demographic offers opportunities for orthotic care
O&P practitioners who have traditionally relied on rehabilitation specialists or orthopedists for referrals need to focus more on primary care physicians and gerontologists as the plus-65 population grows, says Chris Robinson, director of orthotics education at Chicago's Northwestern University. Studies have explored the benefits of ankle-foot and other orthoses in treating a variety of age-related conditions, including balance problems, osteoarthritis in the knee, plantar heel pain and foot injuries. O&P Almanac (Adobe Flash required) (10/2013)
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"Nothing stops" soccer-playing high-school quadruple amputee
High-school sophomore Jorge Dyksen, a quadruple amputee, plays starting forward on his school's junior varsity soccer team. Although he was injured playing soccer in the seventh grade, he got permission from his parents to try again and works with his coach to set his own pace on the field. "I just keep going on and doing what I want to do," said Dyksen, whose aim is to score a goal by the end of the year. ABC News (10/9)
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Breaking news from AOPA
The Office of Inspector General (OIG) responds to O&P Alliance concerns about physician owned distribution entities - read all about it! Get the Noridian prepayment review updates and the Administrative Law Judge hearing time frames. Strike while the iron is hot and take action on the Medicare O&P Improvements Act - send a letter to your representatives today! Ottobock hosts T.O.D.D. Field Day in Minneapolis – a great event! Stay on top of the game with AOPA's last 2013 Coding & Billing Seminar in Las Vegas! All of this in today's AOPA Breaking News.
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Upcoming events
Oct. 22-23: Mastering Medicare: Advanced Coding and Billing Techniques, Las Vegas
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Nov. 13: Advocacy: A Potent Weapon for Change (Telephone audio conference)
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Dec. 11: What's on the Horizon: New Codes for 2014 (Telephone audio conference)
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