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Orthotics and Prosthetics

Coverage

Documentation

Document Type Description
AFO/KAFO Documentation Checklist [PDF] This checklist describes documentation needed for AFO/KAFO claims
Artificial Limbs Physician Letter [PDF] This letter to physicians describes the required documentation for a prosthetic device
External Breast Prosthesis Documentation Checklist [PDF] This checklist describes documentation needed for External Breast Prosthesis claims
Knee Orthosis Documentation Checklist [PDF]  This checklist describes documentation needed for Knee Orthosis claims 
Lower Limb Prosthesis Documentation Checklist [PDF] This checklist describes documentation needed for Lower Limb Prosthesis claims
Spinal Orthosis Documentation Checklist [PDF] This checklist describes documentation needed for Spinal Orthosis claims

 

Reviews/Audits

Review Type Description
Medical Review View notifications and findings of pre and post claim reviews completed by Noridian Medical Review Staff

 

Reminders

Custom Fitted Orthosis

Suppliers who are performing substantial modifications for a custom fitted orthosis must be a certified orthotist or someone with equivalent specialized training such as a physician, treating practitioner, physical therapist or occupational therapist, etc.

Resource

 

Last Updated Aug 18, 2017

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