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Jurisdiction B & C Orthotics & Prosthetics (O&P) POE Advisory Group Meeting Minutes – August 22, 2024

Meeting Date and Time: August 22, 2024, 12:00 p.m. ET

Facilitator: Judie Roan, JC POE Senior Analyst

Advisory Group Members: Curt Bertram, Kimberly Hanson, Aaron Sorensen, Rachel Hatty, Terry Bentley, Joyce Ardrey, Tom Martin, and Danielle Sparks

Agenda

  • Roll Call & Purpose
  • Updates and Changes
  • Suggestions – Last Meeting
  • Educational Feedback
  • Online Tools & Spotlight
  • Upcoming Events & 2024 Educational Planning
  • Feedback & Suggestions
  • Open Discussion

Roll Call & Purpose

Judie welcomed the group, then reviewed the purpose of the advisory group:

  • The primary function of the O&P POE AG is to help CGS in the creation, implementation, and review of provider education strategies and efforts.
  • The POE AG gives input and feedback on training topics, educational materials, and dates and locations of provider education workshops and events.
  • The group also identifies relevant provider educational issues and gives recommendations of how to effectively distribute the information to suppliers and their staff.

Judie reminded the group of the importance of completing the surveys.

Updates and Changes

Judie reviewed information about the changes to the lower limb LCD including the modifiers KX, GA, GY, and GZ; expanded coverage for functional level 2 for microprocessor-controlled prosthetic knees and the compatible feet. The addition and removal of codes from the required prior authorization, written order prior to delivery (WOPD) and face-to-face encounter lists, and retroactive Medicare coverage for prior authorization.

Suggestions from the last meeting:

  • Suggestion: Add custom fabricated items to CGS Connect® (specifically AFO/KAFO).Response: Judie shared this suggestion with medical review.

Educational Feedback & Online Tools

Judie asked if anyone attended webinars, workshops, association meetings, councils, or viewed online education.

A member said they have a new CFO that went to the Nashville workshop, and it was very educational. Another member attended the CMS National Provider Compliance conference and Judie was great and very informational, and the conference was very good. Another member said they use myCGS regularly and it is the best. The members also said they used many of our tools, and they are awesome.

Online Tool Spotlight

Judie reviewed the WOPD Lookup Tool

JB: Written Order Prior to Delivery (WOPD) Lookup

JC: Written Order Prior to Delivery (WOPD) Lookup

Upcoming Events & Educational Planning

Judie presented the list of upcoming webinar topics, workshop locations, and association meetings. She then asked for suggestions and feedback for the educational plan for 2024.

Feedback & Suggestions

When will CGS add the lymphedema compression items to the Advance Modifier Engine (AME)?

Can anything be done to address same/similar for example: cam walkers and custom ankle foot orthoses (AFOs) and upper limb orthoses?

Open Discussion

When will the information about prior authorization non-affirmations be available for AFOs?

The meeting adjourned.

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