O & P Relative Terms/Insurance Information Flashcards
The study of motion and the effect of forces on biological systems.
Biomechanics
To every force, there is an equal and opposite force.
Newtons Third Law
The branch of mechanics that describes the spatial and temporal components of motion.
Kinematics
The branch of mechanics that deals with the causes of motion.
Kinetics
PX Modifications Rule
Repairs may be made without an RX if no big alteration is completed within 90 days (non billable) after 90 days (billable with justification).
Patients Health Info
All information/relating to the care shall always remain confidential and not available to 3rd party unless the patient gives written consent.
Centers for Medicare & Medicaid Services (CMS)
Oversight of medicare, federal portion of medicaid, state children’s health services, and health insurance marketplace.
Durable Medical Equipment - Prosthetics and Orthotics Services (DMEPOS)
Supplier must be enrolled in medicare in order to bill.
Healthcare Common Procedure Coding System (HCPCS)
Level II procedural codes.
L Code
Used to describe an orthotic or prosthetic device, at the most simplest, basic level.
Medicare Orthotic Life Policy
5 years
Medicare Prosthetic Life Policy
3 years
Local Coverage Determinations (LCDs)
National coverage determination - contracted rates for reimbursement.
Date of Service (D.O.S.)
Must be the date that the beneficiary or authorized representative received the device.
Medicaid
A joint federal and state program that helps low income health care. Run by the state.
