O&P Clinical Care Insiders

American Academy of Orthotists and Prosthetists

Join Seth O’Brien, CP, FAAOP(D), as he dissects clinical care topics with leaders of the American Academy of Orthotists and Prosthetists Scientific Societies and the O&P profession. During these 30-minute podcasts, guests will discuss their area of clinical care and share personal experiences as professionals in that specialty and beyond, offering a relaxed journey into the professional lives of those that focus on a specific area of O&P patient care.

  1. 2D AGO

    O&P MythBusters: Common Assumptions Explained

    In this episode, host Seth O’Brien, CP, FAAOP(D), sits down with Lesleigh Sisson, CFo, CFm, founder of O&P Insight, for a MythBusters-style conversation about common misconceptions in O&P clinical practice. Together, they unpack several assumptions that can lead providers astray, including the belief that prior authorization guarantees payment and the importance of accurate enrollment and place-of-service billing for multi-office practices. The discussion also covers payer requests for invoices, clarifying what providers are—and are not—required to supply. The episode highlights key compliance considerations, such as why proof of delivery alone is not enough to justify billing, how standard written orders must be supported by current documentation of continued use, and the role CPO notes can play in supplementing physician records. Seth and Lesleigh also explore issues such as diagnosis-code mismatches, replacement rules within a reasonable useful lifetime, prosthesis eligibility when a power wheelchair is present, and circumstances where additional test sockets may be justified with proper documentation.   Show Notes Lower Limb Prosthetic LCD and Policy Article LCD - Lower Limb Prostheses (L33787) Article - Lower Limb Prostheses - Policy Article (A52496)   Power Mobility Device LCD and Policy Article LCD - Power Mobility Devices (L33789) Article - Power Mobility Devices - Policy Article (A52498)   Standard Documentation Requirements Article - Standard Documentation Requirements for All Claims Submitted to DME MACs (A55426)   Same or Similar Resources Same or Similar: How to Avoid Denials - JA DME - Noridian Same or Similar Chart - JA DME - Noridian   Making Corrections to Medical Records Documentation Guidelines for Amended Records - JE Part B - Noridian   The Medicare Learning Network The Medicare Learning Network® | CMS   Medical Records Requirements MLN909160 – Complying with Medical Record Documentation Requirements MLN4840534_Medical Record Maintenance & Access Requirements Provider Minute: The Importance of Proper Documentation MLN905364 – Complying with Medicare Signature Requirements

    30 min

Ratings & Reviews

5
out of 5
8 Ratings

About

Join Seth O’Brien, CP, FAAOP(D), as he dissects clinical care topics with leaders of the American Academy of Orthotists and Prosthetists Scientific Societies and the O&P profession. During these 30-minute podcasts, guests will discuss their area of clinical care and share personal experiences as professionals in that specialty and beyond, offering a relaxed journey into the professional lives of those that focus on a specific area of O&P patient care.