Making the use of DME and the Medicare Therapeutic Shoe Program easier.

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Correct Coding – RT and LT Modifier

Until now, suppliers billing for bilateral DME devices including therapeutic shoes for patients with diabetes, diabetic inserts, custom AFOs or custom foot orthoses, have been able to submit electronic claims by indicating the total quantity and using the RTLT modifier on a single line OR by using RT on one line and LT on another, noting half the quantity on each.

Beginning March 1, 2019, such claims MUST be submitted using two separate lines, using the RT and LT modifier on each. Units of service (UOS) should be “1″ on each line for shoes and for AFOs; it should be up to “3″ on each line, for prefabricated or custom diabetic inserts. Claim lines for HCPCS codes requiring use of the RT and LT modifiers, billed without the RT and / or LT modifier or with RTLT on a single claim line, will be rejected as incorrect coding.

Suppliers who have been submitting codes for bilateral devices using one line are advised to start billing on two separate lines NOW and not wait until March 1.

As always, each claim line should also include the modifier KX to indicate that all required compliance documentation is on file. When billing L3000 for custom foot orthotic devices, the GY modifier should be used to indicate that the item is statutorily excluded and cause the claim to deny.

For a link to the Medicare carrier website and Policy Articles, see:

https://med.noridianmedicare.com/web/jadme/policies/dmd-articles/2018/correct-coding-rt-and-lt-modifier-usage-change

Helpful Links Using the Medicare DME Portals

Each of the DME MACs have created webpages that offer podiatrists and other DME suppliers access to useful Medicare information.  The “Portals” requires individual registration and uses a personal log-in.  They offer different levels of accessibility and also protects patient personal health information.  Presently Jurisdictions A and D are serviced by Noridian; Jurisdictions B and C are serviced by CGS.

Podiatrists are encouraged to register for the Portals corresponding to the region(s) where their patients reside and to also create access for appropriate staff members.  Some of the things that are certain to prove useful include: Medicare Beneficiary Identifier (MBI) lookup,  info about the Interactive Voice Response (IVR) for checking status of claims, and redetermination.

 

Noridian Medicare Portal (NMP)

Jurisdiction A, Jurisdiction D.

https://www.noridianmedicareportal.com/web/nmp/home

CGS Medicare Portal (myCGS)

Jurisdiction B, Jurisdiction C. 

https://www.cgsmedicare.com/jc/mycgs/pdf/mycgs_registrationguide.pdf

 

Medicare Beneficiary Identifier (MBI) Look Up Tool

A new Medicare Beneficiary Identifier (MBI) replaced the SSN-based Health Insurance Claim Number (HICN) on the new Medicare cards for Medicare transactions like billing, eligibility status, and claim status.

In the past, the HICN was based on a person’s social security number.  Every person with Medicare has been assigned an MBI and has been mailed a new Medicare card.  The MBI is confidential like the SSN and should be protected as Personally Identifiable Information.  The biggest reason for the new MBI is to fight medical identity theft for people with Medicare.

The MBI provides podiatrists and other DME suppliers information need to enter using the telephone key pad when using the IVR and is based only on the information you enter. 

Use this tool to convert the patient’s MBI to the corresponding numbers on your telephone key pad. 

https://cgsmedicare.com/medicare_dynamic/jb/mbiconverter.aspThe Medicare Beneficiary Identifier (MBI) Lookup Tool is an option for providers/suppliers if they are not able to obtain the MBI from the patient.

Noridian DME: Jurisdiction A, D

https://med.noridianmedicare.com/web/jadme%20/topics/nmp/end-user-manual/mbi-lookup-tool

CGS: Jurisdiction B, C

https://cgsmedicare.com/parta/pubs/news/2018/05/cope7584.html

 

Medicare Interactive Voice Response (IVR)

The Centers for Medicare & Medicaid Services (CMS) requires providers to utilize the Interactive Voice Response (IVR) System to check the status of claims.  The Interactive Voice Response (IVR) system requires you to enter your patient’s name and Medicare number during the beneficiary validation process.   The IVR will validate the beneficiary information.

 

Noridian: Jurisdictions A, D

https://med.noridianmedicare.com/web/jeb/contact/ivr

CGS: Jurisdictions B, C

To use the IVR, please call: 877.299.7900

 

Submitting Redeterminations Through the Medicare Portal

When AFO claims are denied and given reason code “M3”, it’s because of “Same or similar”, meaning that Medicare is only covering one device, prefabricated or custom, per side, every five years.  Claims to treat a different diagnosis with a different device, can generally be covered, even after initial denial, if appealed as a “Redetermination”.  Redetermination can be done either by faxing in a form and supporting documentation or via the Portal.  Its recommended that suppliers use the Portal, and not fax, as it provides assurance that all forms are received.  

 

Noridian: Jurisdictions A, D

https://www.noridianmedicareportal.com/

CGS: Jurisdictions B, C

https://cgsmedicare.com/articles/cope25316.html

 

Documentation Identification Tool

CGS has created the Documentation Identification Tool to assist you in submitting the different types of documentation needed to support your claim. Simply select the type of documentation you are submitting from our list of items below. Then print the pre-designed divider sheet and place it in front of the document(s) that will be submitted for review.

The documentation identification tool standardizes the process so you no longer need to create your own divider sheets for your documentation.

https://www.cgsmedicare.com/jc/help/documentation_identification_tool.html

 

Jurisdiction A is serviced by Noridian Healthcare Solutions   and includes Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island and Vermont.

Jurisdiction B is serviced by CGS   and includes Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio and Wisconsin.

Jurisdiction C is serviced by CGS   and includes Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, Virginia, West Virginia and the US Virgin Islands.

Jurisdiction D is serviced by Noridian Healthcare Solutions   and includes Alaska, American Samoa, Arizona, California, Guam, Hawaii, Idaho, Iowa, Kansas, Missouri, Montana, Nebraska, Nevada, North Dakota, Northern Mariana Islands, Oregon, South Dakota, Utah, Washington and Wyoming,

 

Medicare DME Reimbursement Increases in 2019

Good news!
On January 1, 2019, Medicare increased the amount it pays for diabetic shoes, Moore Balance Brace and Arizona custom AFOs.

While the amounts paid may vary slightly by state, the National Fee Schedule is as follows:
Depth Shoes (A5500): pair $146.42
Prefabricated, Heat Molded Inserts (A5512): pair $59.72
Custom Milled Inserts (A5514): pair $89.12
Depth Shoes w/3 pr. Prefab, Heat Molded Inserts: $325.36
Depth Shoes w/3 pr. Custom Molded Inserts: $413.78
Custom Molded Shoes w/offset heels and rocker bottoms: $656.62
Arizona AFO, Standard (L1940, L2330, L2820): each – Ceiling $1178.61, Floor $904.29
Moore Balance Brace (L1940, L2330, L2820): pair – Ceiling $2357.22, Floor $1808.58

For a complete listing of updated DME allowables, including prefabricated and custom ankle-foot orthoses, visit:
https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/DMEPOSFeeSched/DMEPOS-Fee-Schedule-Items/DME19-A.html?DLPage=1&DLEntries=10&DLSort=2&DLSortDir=descending

AFO Custom Diabetic Insert Alert

 

Medicare is now differentiating between custom diabetic inserts fabricated by direct milling and those made by custom molding. Medicare requires that custom diabetic inserts made by CAD / CAM direct milling be billed using new code A5514 when dispensed, replacing K0903, effective January 1, 2019. Inserts provided by SafeStep are made in this way. If SafeStep does your billing, everything will be taken care of for you. If you submit claims yourself or via a billing service, be sure to start using the new custom insert code, A5514.

Both methods of manufacturing result in equivalent final products; reimbursement is also the same, $89.12 per pair, $267.36 for three pairs. Medicare is requiring manufacturers to submit custom diabetic inserts to PDAC for verification and has communicated that custom inserts need not be listed on the PDAC website, dmepdac.com.

If you have any questions, concerns or suggestions, please call our office at 866.712.STEP.

 

AFO DENIALS BASED ON “SAME OR SIMILAR”

The DME MACs have recently begun strictly enforcing a long-existing policy, “Same or Similar.” This situation has resulted in suppliers more frequently receiving denials for DME, indicated on EOBs with reason code “M3.”

Medicare dictates that AFOs can be dispensed only once, per side, every five years. The “Same or Similar” policy states that a beneficiary cannot get another AFO device for the same limb within this period unless the AFO is lost, stolen, or irreparably damaged or the patient has a new diagnosis, resulting in the need for a new type of device.

AFOs considered to be within the same or similar category include both custom fabricated and off-the-shelf including:

L1900, L 1902, L1904, L1906, L1907, L1910, L1920, L1930, L1932, L1940, L1945, L1950, L1951, L1960, L1970, L1971, L1980, L1990, L2000, L2005, L2010, L2020, L2030, L2034, L2035, L2036, L2037, L2038, L2106, L2108, L2112, L2114, L2116, L 2126, L2128, L2132, L2134, L2136, L4350, L4360, L4361, L4370, L4386, L4387, L4396, L4397, L4398, L4631.

For example, a patient receiving a CAM Boot (L4386) in 2017 for a stress fracture on the left foot would likely be rejected for a Custom Fabricated Hinged AFO (L1970) should he or she require one for Posterior Tibial Tendinosis of the left foot in 2019.

Details of the policy can be found at https://med.noridianmedicare.com/web/jadme/policies/lcd/active.

The rule is not provider-specific, meaning that if a patient received an AFO from another provider or supplier within the past five years that was billed to Medicare, the claim for a “same or similar” device may be denied.

What to do about it

Providers can easily discover whether their patient has received a device within the past five years by enrolling in their respective DME MAC Jurisdiction’s Provider Portal. Information on enrolling in the provider portals is available on each DME MAC Homepage.

APMA urges its members not to use the NMBI (National Medicare Beneficiary Identifier) and to continue to use the patient’s Social Security-linked number as there are cases in which the provider portal either will not recognize the NMBI or cannot properly perform a “Same or Similar” inquiry. This issue has been brought to the attention of CMS contractors. Once this issue is resolved, APMA will notify our members.

Once enrolled in a DME MAC carrier’s portal, it will take a minute or less to determine what, if any, devices your patient has received in the last five years. The provider portal will provide you with information regarding the date, HCPCS codes, and name of the supplier who provided the previous device.

The Noridian Provider Portal will only provide “Same or Similar” information regarding services provided in Regions A and D, while MyCGS will only provide “Same or Similar” Information for services provided in Regions B and C.

APMA suggests that providers confirm their patient’s legal address history. This information will minimize any possibility that services were provided previously in a different DME MAC Jurisdiction.

APMA urges members to save any information received on the provider portal. Be sure your chart documentation includes the above information and, if dispensing another AFO for the same side within five years, the fact that a new device is required for one of the several reasons stipulated in the LCD. These reasons include, but are not limited to: The device was lost, stolen, irreparably damaged (due to a one-time event); a different diagnosis; change in anatomy (e.g., amputation, significant weight loss or gain) resulting in the previous device being unusable by the patient; or a different physiologic need (e.g., previous device was for a non-weight-bearing situation and the new device is for a weight-bearing situation).

Suppliers may still initially receive a “Same or Similar” rejection. However, a properly documented progress note including the above information may be used to successfully appeal (Redetermination) a “Same or Similar” rejection.

Providers may obtain the redetermination form from their DME MAC Website and/or provider portal. Once this form is downloaded and completed, you may scan the form (or complete and save it online) and then upload the form and other pertinent information, including response letter and your chart documentation, directly onto the DME MAC provider portal.

By using the provider portal, you may avoid fax transmission errors and be instantly assured that the information submitted has been received by the DME MAC. You may also follow the appeals process via the provider portal and read any comments made by the nurse reviewer. While a redetermination must be completed within a 90-day period (once received by the carrier), it will typically take only 30 days using the provider portal.

Providers may wish to obtain a properly executed ABN, should your search of the provider portal result in a potential “Same or Similar” scenario. A properly executed ABN should be specific as to why your services (new device) may not be covered. Information to include in the ABN should include the name of the device dispensed, date of service, name of supplier, and that any new device may result in a “Same or Similar” rejection.

Recent communication between APMA and the DME MAC Medical Directors seems to indicate that the DME MACs are interested in developing new edits to substantially reduce the number of “Same or Similar” rejections.

This situation is fluid, and APMA urges members to monitor APMA.org for future developments.

Reference: APMA.org

SafeStep representatives can help you:

  • Register for Medicare portal
  • Easily check patient eligibility prior to prescribing AFOs
  • Submit claims for redetermination (appeal) either via Medicare carrier website or via fax.

Contact us at info@safestep.net or 866.712.STEP

MIPS DRIVES SUCCESS BY PROMOTING FALL RISK ASSESSMENT, FITTING SHOES, ORTHOSES & AFOS

Failure to submit Medicare MIPS quality measures will cost physicians tens of thousands of dollars. In 2018, podiatrists have to submit quality measures all year and not for just a 3-month window, like in 2017. Also, the penalty for not submitting increased to 5% of Medicare payments. However, podiatrists should appreciate that performing MIPS measures may also allow billing for office visits and will increase awareness of when balance AFOs, payable by Medicare, should be prescribed.

DON’T BE HIT WITH MIPS PENALTIES: DOWNLOAD THE LATEST MIPS FALL RISK ASSESSMENT TOOL HERE

MIPS quality measures 154, falls risk assessment and 155, falls, plan of care, address falls being the leading cause of injuries for older adults. One in four Americans aged 65 and over falls each year. By identifying people with gait instability, podiatrists can reduce this risk and make fall prevention a valuable part of their practice.

Physicians should annually, ask every patient, 65 and over, whether they have fallen in the past year. If so, they should follow-up by asking how many times and if the patient suffered an injury. Patients who have fallen two or more times or once with injury are defined to be at high risk.

These patients should be evaluated using a fall risk assessment form available from SafeStep.
Gait, strength and balance are assessed by having patients perform a “Timed Up and Go Test”. Patients stand, walk 10 feet, turn around and sit down. If TUG takes more than 12 seconds, there’s a good chance such conditions as: muscle weakness, difficulty walking or unsteadiness on feet are present.

MIPS 154 also requires assessing another contributing factor to falling including:
• a review of medications, or
• asking if the patient has had an eye exam in the past year, or
• reviewing other possibly contributing medical conditions, or
• determining the presence of postural hypotension.

Patients should be provided with a Plan of Care that includes balance, strength and gait training instructions, advice about vitamin D and information about home fall hazards. To make it easy, when using the assessment form available from SafeStep, simply tear off and give the patient a sheet that’s part of it.

When patients have NOT fallen two or more times or once with injury, submit MIPS quality measure 154 using CPT code 1101F.

If patients at high risk for falls are evaluated and provided a plan of care, consider billing E&M code 99213. Also submit codes 3288F and 1100F for MIPS 154 and 0518F for MIPS 155.
When there is fall risk, based on gait assessment, consider prescriptions for balance footwear, foot orthotics and possibly balance AFOs.

SafeStep has available, for free, copies of a Fall Risk Assessment form that assists in satisfying the MIPS fall prevention requirements. Medicare compliance documentation for AFOs can be best assured by using SafeStep’s WorryFree DME program.

Medicare DME Reimbursement Increases in 2018

Good news!
On January 1, 2018, Medicare increased the amount it pays for diabetic shoes, Moore Balance Brace and Arizona custom AFOs.

While the amounts paid may vary slightly by state, the National Fee Schedule is as follows:
Depth Shoes (A5500): pair $143.12
Prefabricated, Heat Molded Inserts (A5512): pair $58.38
Custom Molded Inserts (A5513): pair $87.12
Depth Shoes w/3 pr. Prefab, Heat Molded Inserts: $318.26
Depth Shoes w/3 pr. Custom Molded Inserts: $404.48
Custom Molded Shoes w/offset heels and rocker bottoms: $570.38
Arizona AFO, Standard (L1940, L2330, L2820): each – Ceiling $1178.61 Floor $883.96
Moore Balance Brace (L1940, L2330, L2820): pair – Ceiling $2357.22 Floor $1767.92

For a complete listing of updated DME allowables, including prefabricated and custom ankle-foot orthoses, visit:
https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/DMEPOSFeeSched/DMEPOS-Fee-Schedule-Items/DME18-A.html?DLPage=1&DLEntries=10&DLSort=2&DLSortDir=descending

MIPS DRIVES SUCCESS BY PROMOTING CDFE AND SHOE FITTING IN 2018

Failure to submit Medicare MIPS quality measures will cost physicians tens of thousands of dollars. In 2018, podiatrists have to submit qualify measures all year and not for just a 3-month window, like in 2017. Also, the penalty for not submitting increases to 5% of Medicare payments. However, podiatrists should appreciate that performing MIPS measures may also allow billing for office visits and will increase awareness of when shoes and inserts, payable by Medicare, should be prescribed.

MIPS quality measures 126 and 127, diabetic foot exam including evaluation of footwear, address the association of neuropathy with diabetic foot ulceration. Properly fit shoes have been demonstrated to significantly reduce the likelihood of foot ulceration in patients with diabetes. By identifying people who qualify for shoes paid for by Medicare, podiatrists can make shoe fitting a valuable part of their practice.
Podiatrists should annually perform an ulcerative risk assessment on every patient with diabetes. A CDFE should include testing for loss of protective threshold using a 10-gram monofilament plus at least one of the following neurological exams including feeling vibration using a tuning fork, pinprick sensation, or ankle reflexes. Testing should also look for vascular, dermatological and structural findings. The foot should be sized using a standard measuring device, and the patient counseled on appropriate footwear based on risk categorization.

Patients with Medicare and diabetes who are identified to be at increased risk for ulceration should be fit with shoes and inserts. Shoe fitting will be most successful when patients are recommended models based on the consideration of what’s referred to as the 4 S’s of shoe fitting: Size, Shape, Stability & Style.

When patients with diabetes are given a comprehensive diabetic foot exam and provided a plan of care, which may include prescribing shoes, consider billing E&M code 99213. Also, submit codes G8404 for MIPS 126 and G8410 for MIPS 127.

SafeStep has available, for free, copies of a CDFE form that assists in satisfying the MIPS diabetic foot examination requirements. Medicare compliance documentation for diabetic shoe-fitting can be best assured by using SafeStep’s WorryFree DME program.

To access SafeSTep training and webinars, visit:

DME Training

Free Webinar Instructionals

Essentials For Diabetic Shoe Fitting Success By Josh White, DPM, CPed

I recently visited a team a podiatrist’s office. They have been a part of the Therapeutic Shoe Program and fitting diabetic patients with shoes for many years. I appreciated their interested in learning how they could improve what could be considered a “good” shoe program, and in going from “good” to “better” or even “great.”

All staff members were encouraged to attend, including: the front office person, who is the eyes and ears of the practice, and who reminds the doctors which patients have diabetes and are due for an annual comprehensive diabetic foot exam (CDFE); the fitting person, who measures, fits and laces patients’ shoes – critical to the program’s success.

We reviewed how the Medicare Therapeutic Shoe Program provides win – win – win benefits for all: patients benefit by getting shoes they need for little or no cost, by doing so, they also decrease their risk for ulceration and amputation, and the office makes money while improving patient satisfaction (and Medicare actually reduces costs).

We reiterated the importance of clearly defining each step in the evaluation and shoe fitting process, and confirmed that while there could be more than one person performing each task, there must be a single person responsible for its execution.

And lastly, we defined the metrics for determining the success of each step – as well as for the program overall.

Here are the steps and how to determine successful execution:

  • Determine the number of patients in the practice with Medicare and diabetes. Every patient should have a dedicated visit for an annual comprehensive diabetic foot evaluation (CDFE) scheduled on a separate visit. This visit can performed by or overseen by the DPM and billed as 99213 if a predisposing condition of ulcerative risk is determined and a plan of care prescribed. Printed copies of the CDFE form are available, for free, from SafeStep upon request. Here is a link to the form: http://safestep.net/safestep/PDF/CDFE(Interactive).pdf?id=431. Note: Someone should track the number of CDFE exams performed (on an ongoing basis), and compare it to the number of patients with diabetes in the practice.
  •  Conservatively, 75% of patients with Medicare and diabetes will have a qualifying risk factor and should be prescribed therapeutic shoes. When scheduling patients, either have a shoe fitting person in the practice available to assist on that day or consider OHI’s Central Casting Program, an on-site Pedorthic service availing Certified Pedorthist to assist podiatrists with examining, casting and fitting patients.
  • Every shoe fitter and CPed should use the “4S’s approach to shoe fitting” which are: Size, Shape, Stability, Style to fit and pair the shoes that meet each patients’ aesthetic desires and therapeutic needs. It’s important to have shoe samples in the styles patients most prefer, and to update them periodically. Fitting displays or a small fitting inventory will go a long way to improve fitting success and patient satisfaction. Patients whose fitting needs exceed what’s possible with depth shoes should either be casted for custom molded shoes or referred to a local footwear clinic. The SafeStep website displays the practice’s “Fit Rate”. If not 85% or better, help is available to fit at least as well as is done by the average office.
  • Use SafeStep’s WorryFree DME program to create Medicare compliance documentation and to procure required authorization from the certifying MD physician. SafeStep’s team of professionals and dedicated services help you save time, and build your practice.
  • When dispensing shoes, emphasize to patients the importance of daily footcare and self-examination to check for signs of ulceration. Encourage them to wear their fitted shoes and inserts as a preventative measure, and to return on an annual basis to be re-evaluated for replacement shoes each year.
  • The true indicators of a successful diabetic shoe program is when the number of shoes fitted increases each year, and the number of wounds treated decreases. While some practices have been deterred from fitting shoes because of the effort required and concerns about Medicare audits, many enjoy the success that this preventative care indicative was intended to achieve. Read the article “Keys for Success for Fitting Diabetic Shoes” to learn more.
  • Qualifying patients should be scheduled for an evaluation and fitted with shoes annually. Despite the benefits, most practices refit less than 25% of patients from one year to the next when all it takes is an outreach effort to patients from each year. Your SafeStep homepage displays the practice “Repeat Rate”. There are tools available, including patient lists, which can be used to facilitate a recall program, to ensure that every patient is evaluated annually to be refit with replacement shoes. To better understand the true value to your practice, read “The $40,000, 4 Hour per Week Diabetic Shoe Program”. The article describes how little time is actually needed, if the program is organized effectively, to yield significant benefits to patients and to the practice.
  • Successful practices set goals at the beginning of each year and monitor their performance on an ongoing basis. To recap, key metrics for ensuring program success include:
    1. The number of annual CDFE’s performed on patients with Medicare. Compare to the number of patients with Medicare and diabetes in the practice. Every patient should have at least one annual evaluation.
    2. The number of shoe fit, covered by Medicare. Conservatively, 75% of patients with Medicare and diabetes will have a qualifying risk factor and should be fit with shoes.
    3. Shoe fit rate. Should be 85% or better. Track on SafeStep Members Home Page. If lower than it should be, assistance is available to help improve.
    4. Refit Rate: Should be 75% by end of year.

Successful practices create incentive programs to reward staff members responsible for each of these key metrics.

  • Further assistance is available by scheduling a One-on-One Training Session with a SafeStep DME Specialist. Topics include:
  • “The WorryFree DME Shoe Ordering Process”
  • Diagnosis Specific DME Treatment Protocols for AFOs
  • AFO and Shoe Compliance Documentation
  • 18 Surefire Ways to Improve Your Shoe Fitting
  • Fall Risk Management Made Easy with Moore Balance
  • The CDFE Strategy

I hope you find this article helpful. I truly enjoy writing these articles and working with practices to help them become more successful. Our friendly SafeStep customer service team is available to assist you with your account and all programs, products, services.

Keys for Success: Fall Risk Prevention … It’s a Best Practice!

The SafeStep Keys for Success that you’ll see here are based on real examples from podiatrists and can dramatically improve your practice.

October Key for Success: Set Up a Fall Risk Prevention Program

On an annual basis, it is important to ask every patient 65 years of age and older, if they have fallen in past year. This is a baseline for a fall-risk assessment and is a precautionary measure to help more patients.

If patients have not fallen or have fallen once without injury, consider them to be NOT at high risk for falls.

If patients have fallen once and been injured or two or more times without injury, consider them to BE at high risk for falls and use SafeStep’s “Functional Fall Risk Assessment Tool” to determine the basis for increased risk.

If fall risk assessment determines the increased risk to be orthopedic in origin, perform a “Biomechanical Evaluation” to determine the specific etiology and guide a plan of care. Such a plan might include:

  • Offering assistive devices including canes and walkers for those at risk.
  • Providing patients guidance about footwear options that will enhance stability.
  • Consideration of foot orthoses that can decrease foot pain and improve support.
  • Providing physical/occupational therapy options.
  • When appropriate, casting for bilateral Moore Balance Braces.
  • Its appropriate to bill an EM charge when fall risk is determined and a plan of care provided.

In order to learn more about how to get started:

1.     Read articles in library section of SafeStep website.

2.     Register at SafeStep.net for the training webinar: “Fall Risk Management with Moore Balance”.

3.     Call for SafeStep at 866.712.STEP for patient information brochures, order forms, free mailing labels and STS casting kit.

4.     Review the semi-weightbearing casting technique. Video located in AZ AFO section of SafeStep website, Library section.

5.     The SafeStep website features all Medicare required compliance documentation.