MY PATIENT’S ORTHOTICS ARE SQUEAKING IN THEIR SHOES?
Have your patients give a good dusting of baby or foot powder. If that does not work try applying a small amount of paraffin.
WHAT IS YOUR STANDARD REARFOOT POST?
It depends on the type of device you order. If you do not request a specific amount of posting, we do the standard posting for that device posted vertical to the forefoot.
MY PATIENT’S ORTHOTICS KEEP BREAKING?
Heavy patient- the arches need to be reinforced or the shell needs to be made thicker, if available. Outgrowth- children’s orthoses that break in the heel cup area are almost always due to outgrowth. If the devices are close to a year old and broken, the patient needs to be re-casted. Abnormal usage- if the patient uses ladders, shovels, or anything which would cause stress to the bottom of the orthotic, it will probably break. This type of breakage is not covered by our warranty. Some solutions are to use a shell with a little more give to it such as polypropylene or reinforce the arch with crepe.
MY PATIENT’S HEEL KEEPS POPPING OUT OF THE SHOE?
The heel of the orthotic may be too thick. May want to try a modified intrinsic rearfoot post. If there is rearfoot posting, lower it. If there is extra cushioning in the heel, thin it out. If there is arch reinforcement, remove some or all of it. Occasionally, the heel may pop out of the shoe when the orthotic is not contoured properly for a dress shoe.
MY PATIENT’S ORTHOTIC KEEPS SLIPPING AROUND IN THEIR SHOE?
First check to make sure the orthotic fits the foot correctly. If it does you may add a full length top cover to fill up the toe area in the shoe.
I HAVE SOME QUESTIONS ON YOUR IN-TOE AND OUT-TOE CHILDREN’S ORTHOTICS?
A Gait Plate Induce In-toe is shaped basically like a normal orthotic with an extension on the plantar medial surface which will induce in-toe. The Gait Plate Induce Out-toe is shaped basically like a normal orthotic with an extension on the plantar lateral surface which will induce out-toe.
HOW CAN I GET STARTED USING THE RICHIE BRACEÂ ON A PATIENT?
Allied OSI Labs has trained Client Service personnel who can help you with every aspect of Richie Brace® treatment from providing casting instructions, clinical indications as well as coding and reimbursement information.
HOW DO I KNOW IF MY PATIENT IS A CANDIDATE FOR THE RICHIE BRACE®?
Review the clinical indications outlined for each brace. If your patient does not fit into one of the distinct categories, or if there are special considerations such as body weight, paralysis etc. then call the Client Service department.
CAN THE RICHIE BRACE® BE USED FOR SPORTS ACTIVITY?
The Richie Brace® was originally designed for sports applications. Dr. Douglas Richie, a practicing sports podiatrist, had encountered difficulty fitting his patients with ankle braces while allowing the patient to continue wearing the custom foot orthotic he had prescribed. Still today, many popular ankle braces do not fit in shoes well and do not support the foot. Thus, the Richie Brace® was born: a form fitted custom ankle brace that incorporates a foot orthotic. This brace is ideally suited to treat lateral ankle instability, tendon injuries around the ankle joint, and aid in recovery from Grade II and III ankle ligamentous injuries. The Richie Brace® has been used by many collegiate, professional and olympic athletes with remarkable success.
DOES ALLIED OSI LABS EXCEPT THE RICHIE BRACE® BACK FOR CREDIT IF THE PATIENT REFUSES THE BRACE?
No, the Richie Brace® is custom and made specifically for that patient. When a Medicare patient refuses a DME product, the dispensing doctor can bill Medicare for the invoice amount. Use the normal codes and give an explanation in the box of patient refused the brace
WHAT IS THE WEIGHT LIMIT ON THE RICHIE BRACE®?
There is no weight limit.
WHAT ARE YOUR SHOE RECOMMENDATIONS FOR THE RICHIE BRACE®?
The shoe requirements are the same as what we recommend for orthotics. A removable food bed, deep heel pocket and a stiff shank. We recommend SAS Time Out and Free Time as well as any motion control running shoes.
HOW OFTEN CAN I BILL FOR A NEW RICHIE BRACEÂ®?
You can bill Medicare for a new AFO brace when the current brace is no longer serving a useful purpose or addressing the patient needs from a medical necessity standpoint.The guidelines are vague on a time frame. The chart notes should reflect the reason an AFO brace should be replaced and the medical necessary should justify a change of brace.
CAN YOU BILL FOR A BRACE WHEN THE PATIENT CAN NOT TOLERATE THE BRACE OR IF IT IS NOT HELPING THE PATIENT?
Yes, bill for the invoice amount of the brace only.
DO RICHIE BRACE® CLAIMS REQUIRE A KX MODIFIER?
All claims submitted to Medicare for AFO’s must have a KX modifier for ALL codes including the parent code for the brace as well as all the additional codes such as soft interface etc.. All claims for AFO’s submitted to Medicare which do not have a KX modifier will be rejected. Attempts to re-submit the claim with the correct modifier will again be rejected. Call the DME MAC regional provider and ask for a “re-opening” of the claim. A few questions will be asked on the phone about the provider’s number and claim number. Then, the rejected claim should be paid within approximately 3 weeks as long as the KX modifier is added to all the codes.
IS THERE A LESS AGGRESSIVE DORSIFLEXION HINGE FOR THE DYNAMIC ASSIST®?
We have 3 hinge rigidities. 85 durometer is our standard hinge, we have a 75 which if less aggressive and 95 for maximum dorsiflexion power.