ASHT Orthosis Denial Data Collector

Attention all ASHT members - ASHT needs data from you!

ASHT has been collaborating with the American Occupational Therapy Association and the American Physical Therapy Association and the Academy of Hand and Upper Extremity (APTA) in an effort to address a problem with orthosis denials and CMS. CMS has a rule that a patient cannot receive the same orthosis code within a five-year timeframe (the “Reasonable Useful Lifetime"). This is problematic for hand therapists who custom fit and fabricate orthoses for a number of reasons:

  1. Many orthoses that are worn regularly do not last five years
  2. Patients lose or break their orthoses
  3. Many of the L codes apply to a wide variety of designs
  4. Patients can have different conditions occur during this timeframe that require the same L code
  5. The appeal process is cumbersome, and most times does not elicit an approval of the orthosis

We are asking that ASHT members and hand therapists across the country submit information about denials you have seen related to reasonable useful lifetime restrictions. Our goal is to gather data to demonstrate the continued impact this is having on practitioners.  Please do not include patient names or identifiers in your submissions.

Thank you in advance for taking the time to provide us with information regarding the Medicare orthosis denials you have experienced.  If you have multiple cases of these denials, please enter each denial. At the end of the survey you will be able to continue entering additional examples of denials.

Data Related to the Denied/Second Orthosis Provided:
ABN Utilization
Comments
Contact Information
We would like to be able to follow up if there is any clarification related to data provided. It would be greatly appreciated if you could provide your contact information. You will not automatically be contacted but only if there is clarification needed.