Medicare AFO Height Requirement Rescinded

As expected, the height requirement for an AFO is being removed by medicare.

Let’s get on with helping people walk!

Below is the text from the Medicare website:

February 6, 2013

Ankle-Foot Orthoses/Knee-Ankle-Foot Orthoses LCD related Policy Article – Revised
The related Policy Article for the Ankle-Foot Orthosis/Knee-Ankle-Foot Orthosis is being revised. The Policy Article with an effective date of January 1, 2013 included Coding Guidelines for AFOs that included a height requirement. The height requirement is being removed. The effective date for the revised Policy Article is for dates of service on or after January 1, 2013.

See for yourself here:
http://www.cgsmedicare.com/jc/pubs/news/2013/0213/cope21209.html

Again, the only type of AFO that requires a PDAC Coding verification letter is the L1906. Insightful does not use that code for any of its current bracing. To verify this for yourself, please see the PDAC website listing those that are required. The link to this page is below.

https://www.dmepdac.com/review/items_requiring_coding_verification_reviews.html

Finally, keep in mind that the pretibial shell that has been offered by our competitors is essentially a custom shin guard, the argument that this provides axially unloading as medical justification is risky in our opinion.

Foot of the Week – Episode 25 – Best Post Tib Brace

In this video blog, we discuss the importance of casting the post tib patient’s foot and ankle in a neutral position. If the cast is taken in a full weight bearing position, it can be difficult to provide the needed correction to the AFO or custom ankle brace for posterior tibial tendonitis.

Foot of the Week – Episode 18 – Toe Off

In this week’s video blog, we compare the differences between braces designed for toe off and braces designed for drop foot. Braces designed for toe off are supposed to help in gait with plantarflexion, not dorsiflexion. Braces designed for drop foot or foot drop are supposed to help in gait with dorsiflexion, or lifting the foot up and not pushing off with weak toes. Some of these toe off brace designs do give clearance at swing phase, allowing the toes to clear the ground while swinging the leg forward, but most do not help with shock absorption at heel strike. A key component to any good drop foot brace is the ability to slow the foot down at heel strike thereby preventing foot slap while also not restricting plantarflexion too much. The reality is that most of these toe off designs are not strong enough to assist in toe off. As seen in this video, the brace bends almost beyond its limit at about 15 lbs and most people weigh between 120 and 200 lbs. Even though the toe off is made of carbon fiber or mostly carbon fiber, the designs we have looked at can not handle weight over 100lbs and therefore the toe off benefit claimed is worthless in our opinion.

Foot of the Week – Episode 15 – Ankle Foot Orthosis Straps

http://www.insightful-products.com
In this Week’s vblog, we talk about the use of the term orthotic and how it is more than just a word to describe the Foot orthotic but also the AFO or Ankle Foot Orthosis. Also, we discuss AFO straps and how simple it can be to adjust your strap’s length by simply cutting excess material. We have many foot and ankle patients that dont feel comfortable altering the brace strap but so long as you leave enough of the strap to fasten the brace to the foot and ankle, its fine to cut off the excess material to make the adjustment.

Foot of the Week – Episode 9 – AFO Solutions

http://www.insightful-products.com

In this weeks vblog, we demonstrate the AFO strategy used by Insightful to attach the AFO or ankle brace to the shoe using velcro.  The foot and ankle brace is attached to the shoe using hook and loop pile.  By attaching the ankle brace to the shoe, the unit becomes one.  All of Insightful’s bracing is designed to work with a shoe and not without a shoe.  Fastening the brace to the shoe makes it easier to don the brace or to put the brace on but also keeps the brace placed back in the heel of the shoe.  This keeps the brace from creeping forward in the shoe and using up space in the shoe.

Foot of the Week – Episode 8 – AFO solutions

http://www.insightful-products.com

In this Week’s vblog, we focus on a spastic foot and ankle and how an articulated ankle foot orthosis (AFO) will not control plantarflexion. Insightful will manufacture a 3 point pressure system AFO that will help control the deformity.

Foot of the Week – Episode 6 – AFO Solutions

In this week’s video blog, we show you our preferred method of “ankle brace casting” for a custom AFO. Although, we will take any type of cast, we prefer the STS sock, ranging from STS slipper casts, 3/4 length STS casts and full length STS sock casts. The STS slipper sock would be suitable for the Step-Smart as we only need the plantar surface of the foot (a partially weight bearing foam box impression also works for the Step-Smart brace for foot drop). A 3/4 length STS cast works well for any of our Blaze braces (designed for early stage Post tib or typical ankle instability issues) where the cast goes just above the malleoli, and the full length STS sock works best for the Schooner style Gaunlet brace (designed for late stage post tib) which is similar to the Arizona brace.

For more information, call us at 207-885-0414 or see our website at http://www.insightful-products.com

Foot of the Week – Episode 5 – AFO Solutions

In this week’s video blog, we show you some of the pitfalls of brace casting for AFO’s and our preferred method of “ankle brace casting” for a custom AFO. We cover some of the common mistakes of brace casting as well as the various types of casts ranging from STS slipper casts, 3/4 length STS casts and full length STS sock casts.

For more information, call us at 207-885-0414 or see our website at http://www.insightful-products.com