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

Physician Login/Register

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:

New Billing Codes for Plantar Fascia Night Splints, Pneumatic and Non-pneumatic Walking Casts

Medicare now differentiates between off-the-shelf and custom fitted type prefabricated AFOs including pneumatic and non-pneumatic walkers and plantar fascia night splints.

Traditionally used codes reflect the custom fitted version and the allowable amounts for both are currently the same.  For devices traditionally billed using L4360, L4386 and L4396, new codes reflecting the off-the-shelf definition most likely apply.

Click below to read entire article:


Effect of Sequestration on DME

Questions and AnswersQuestion: Does the 2% payment reduction under sequestration apply to the payment rates reflected in Medicare fee-for-service fee schedules or does it only apply to the final payment amounts?

Answer: Payment adjustments required under sequestration are applied to all claims after determining the Medicare payment including application of the current fee schedule, coinsurance, any applicable deductible, and any applicable Medicare Secondary Payment adjustments. All fee schedules, Pricers, etc., are unchanged by sequestration; it’s only the final payment amount that is reduced.

Question: How is the 2% payment reduction under sequestration identified on the electronic remittance advice (ERA) and the standard paper remittance (SPR)?

Answer: Claim adjustment reason code (CARC) 223 is used to report the sequestration reduction on the ERA and SPR.

Continue Reading…

Shoe Orthoses Reduced Diabetes-Related Amputations

Long-term use of shoe orthoses significantly reduced diabetes-related amputations, according to study results recently presented at the International Society for Prosthetics and Orthotics World Congress in Hyderabad, India.

Researchers studied 114 Swedish patients with diabetes and a risk of developing foot ulcers. Over 2 years, patients wore one of three different types of shoe orthoses.

Results showed that the use of orthoses, podiatry, education and regular check-ups helped patients avoid foot ulcers. Overall, only 0.9% of participants developed new foot ulcers during the first year vs. an industry average of 3% to 8% reported in similar diabetic populations.

Continue Reading…


Loss Of Balance Is Leading Cause Of Elderly Falls

by Jessica Stoller-Conrad

Accidental falls are one of the leading causes of injury death in people over 65 worldwide, but for a long time researchers have struggled to understand just how they happen.

What they do know is that many older patients have cognitive impairment, and even the most conscientious medical staff can have trouble remembering details of a fall. So a group of researchers in British Columbia decided to use a round-the-clock video in a long-term care facility to observe accidental falls right as they happen.

Their study, published in the The Lancet, found that most of the 227 falls caught on video happened because the patients lost their balance, not because they slipped or tripped.

But what causes this momentary loss of balance?

Continue Reading…

Be an AFO Expert – It’s Easy if You Use DME Protocols

Time and time again I am asked the same four questions about AFOs:

  1. When should they be used
  2. What’s the correct diagnosis code
  3. What HCPCS code should be used for the AFO
  4. How much does it pay?

While Medicare does not offer definite answers to any of these questions, it does offer guidance in the form of LCDs, Letter of Common Determination and fee schedules.

SafeStep features free webinars on DME Treatment Protocols and another on Compliance.  To register, simply click here, http://www commande  Recorded versions of presentations can also be found in “Library” section of SafeStep website. Even if you have seen this presentation in the past, it’s worth attending again as codes and requirement continue to change.

In collaboration with leaders of the American Academy of Podiatric Management and other knowledgeable practioners, SafeStep created the DME Treatment Protocols booklet.  This guide offers a step by step approach to devices that will effectively work for the most commonly seen biomechanical conditions and offers guidance of how to bill and how much to charge.  While not intended to be followed explicated, it offers practioners an effective starting point and way to developer’s ones own approach to care.  To get your copy of this valuable guide, cont

Once protocols are established, they should be combined with an effective inventory management routine so that the office is certain to always have in stock products for the most commonly seen condition but not so much inventory as to take up valuable office space.  When effectively implemented into office routines, staff should put possible devices out for the doctor to consider so that easily available to discuss with the patient.  If indicated for a Medicare patient, the device can be dispensed on the spot, no prior authorization is necessary.

Gait Evaluation Determined to be Effective Early Indicator of Dementia

The New York Times recently reported  that gait evaluation can be an accurate early indicator of Alzheimer’s disease and other  causes of cognitive impairment.  Studies show that when people’s thinking slows, their walking ability declines almost in parallel.   Experts say that by focusing on gait, physical therapists and doctors may be the first to recognizing dementia and offer approaches to improve mobility.  There is also speculation that exercises to improve fitness and coordination can help stave off dementia.

To read the article, click here:

New Foot Ulcer Treatment Under Scrutiny from FDA

Here’s something I found that I thought is interesting and thought you would want Boredom to see this news.

Sanuwave, maker of the New dermaPACE diabetic foot ulcer treatment, received a letter from the Food and Drug Administration (FDA), asking the company wholesale nfl jerseys to run another clinical trial of its wave-based product. Forex According to the FDA, Wholesale San Francisco 49ers Jerseys the initial run failed to meet its primary endpoint.

Using extra-corporeal shock wave technology, Sanuwave’s product is unique to the marketplace, but Team requires more testing, according enhancements to the FDA. According to a press release, the data shows the Thermal wound closure did indeed succeed, after additional time of 24 weeks.

To see the whole story about Sanuwave, take a look at the of entire article here:

Have of you heard of this technology and would you consider cheap nba jerseys adding it to your practice?

Providing Better Care With New Technology

As we move Dark into 2012, Podiatry professionals should look at different ways to improve the care for their patients. This is what I cheap nfl jerseys found in this article in Healthcare IT News about a podiatrist that has adopted the iPad in his practice. By adding it in, he now has something small wholesale jerseys China enough to carry room to For room and gives wholesale jerseys him more time with his patients.

Going into 2012, let’s look at how we cannot only increase Bienvenue our bottom-line, but at the same time, increase the quality of care for patients.

To see the entire article, find it cheap jerseys here: find owner of a domain .