Tag: Joe McTernan
Proposal increases access to ‘technological leap forward’
February 16, 2024Theresa Flaherty, Managing Editor
WASHINGTON – O&P stakeholders hailed a new proposal by CMS to expand coverage of microprocessor-controlled knees for certain K2 patients, something they say is long overdue.
Under the proposed changes, the agency will no longer limit the technology to patients classified as K3 and above.
“When this technology first came about in the in the 90s, it was really marketed and touted as kind of like the next technological leap forward for patients,” said Joe McTernan,...
AOPA readies to monitor new prior auths
March 13, 2020Theresa Flaherty, Managing Editor
WASHINGTON - The American Orthotic & Prosthetic Association is “interested” to see how the new prior authorizations for certain L codes work out, says Joe McTernan.
CMS in February announced it was adding six lower limb prosthetic codes to the prior authorization list for DMEPOS.
“We are hoping to track the affirmation rates, both positive and negative, to see what the impact is on beneficiaries and how we can respond to that,” said McTernan, director of coding and...
Coding project reveals outdated guidelines
October 20, 2017Theresa Flaherty, Managing Editor
WASHINGTON - A coding redetermination project for custom diabetic inserts could be a sign of the times, where guidelines don't keep pace with technology.In August, the Pricing, Data Analysis, and Coding Contractor announced it would initiate the project for A5513 after the DME MACs issued a joint publication stating that, to meet the requirements of that particular code, the insert must be molded over an actual model of the patient's foot.Although many models are still made using older methods like...