05/15/2023    

PODIATRIC PODCASTS

CA Podiatrist Discusses How to Get Insurance to Cover AFOs

 

Don Pelto, DPM recently discussed the same or similar rules and how to explain AFOs to your patients with Doug Richie, DPM on Dr. Pelto's podcast Podiatry Practice Mastery. Dr. Richie recommended when prescribing AFOs to use guidelines from Medicare as the standard for AFO coverage. He continued by saying that the useful lifetime of an AFO should be five years. 

 

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Regarding the same and similar rules, Dr. Richie stated there are other types of DME items in the same or similar description categories that can make prescribing braces more challenging in private practice, and there is a Medicare portal to determine if the patient has received DME in the past five years. If there is a different device, document why it is medically necessary for your charts and be prepared to file an appeal if denied.