MACs retire ‘Dear Physician’ letter for limbs

Wednesday, May 9, 2018

WASHINGTON – The DME MACs are retiring the “Dear Physician” letter for artificial limbs, according to a bulletin from the American Orthotics & Prosthetics Association. The letter is being retired following recently passed legislation that requires the recognition of the prosthetists’ notes as part of the patient’s medical record. The letter, originally published in 2011, dramatically changed the standards for approving a prosthetic claim by disregarding the prosthetist’s notes as part of the medical record, leading to higher claim denial rates, according to AOPA. The association in 2013 sued CMS over its auditing practices.