Comprehensive Error Rate Testing audits are intended to control Medicare fraud and abuse, but unlike others, CERT audits are designed to measure the performance of claims contractors rather than providers. Nevertheless, the results can trigger increased scrutiny and prepayment audits, explains AOPA’s Director of Coding and Reimbursement Services Joseph McTernan, so O&P providers should be sure they understand applicable medical policies, boost communications with their referral sources and perform internal audits on a regular basis.
The International Society for Prosthetics and Orthotics opens its global conference in Hyderabad, India, on Feb. 7. The ISPO World Congress is the first to be held in India and South Asia, and organizers expect more than 1,000 delegates from 84 countries. Changing demographics, lifestyle-generated disorders and other factors are creating growing demand for O&P professionals, said ISPO President Jan H.B. Geertzan.
Using medical-grade maggots to clean dead tissue from hard-to-heal wounds can help prevent amputation, according to a doctor in Branson, Mo., who said, “They clean the wounds by dissolving dead and infected tissue, they disinfect the wound and they speed up the rate of healing. They ... help bring blood supply to the surface, allowing for new cell growth.”
As the durable medical equipment industry grows, the cost of DME fraud could fall between $1.5 billion and $5 billion in a single year, according to a report by the National Insurance Crime Bureau. The bureau applied the FBI's 2011 estimated fraudulent billing percentages to DME projected spending to arrive at those figures.
The issue of phantom limb pain was the subject of an episode of the television series "Grey’s Anatomy," as the character Dr. Arizona Robbins coped with the aftermath of her leg amputation. While the character is fictional, she is dealing with a very real problem, writes author Dr. Michele R. Berman.