june 2012 almanac

OP&WWW.AOPANET.ORG

THE MAGAZINE FOR THE ORTHOTICS & PROSTHETICS INDUSTRYOP&WWW.AOPANET.ORG

The American Orthotic & Prosthetic Association JUNE 2012

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CONTENTSJUNE 2012, VOLUME 61, NO. 6

O&P Almanac (ISSN: 1061-4621) is published monthly by the American Orthotic & Prosthetic Association, 330 John Carlyle St., Ste. 200, Alexandria, VA 22314; 571/431-0876; fax 571/431-0899; email: [email protected]. Yearly subscription rates: $59 domestic; $99 foreign. All foreign subscriptions must be prepaid in U.S. currency, and payment should come from a U.S. affiliate bank. A $35 processing fee must be added for non-affiliate bank checks. O&P Almanac does not issue refunds. Periodical postage paid at Alexandria, VA, and additional mailing offices. Postmaster: Send address changes to: O&P Almanac, 330 John Carlyle St., Ste. 200, Alexandria, VA 22314. For advertising information, contact Dean Mather, M.J. Mrvica Associates Inc. at 856/768-9360, email: [email protected].

OP Almanac&

JUNE 2012 O&P AlmAnAc 3

Cover Story

Feature

SPeCIaL Feature

50 O&P Buyers’ Guide 2012The 2012 Buyers’ Guide is a must-have resource filled with in-depth information about products and services related to the O&P industry. This handy directory also features a comprehensive index of manufacturers and AOPA member suppliers for easy reference.

COLUMNS

16 Reimbursement PageMaking the most of accounts receivables

32 Ask the Expert Decoding the mysteries of inpatient billing

36 Facility Spotlight Mary Free Bed Rehabilitation Hospital

dEPARtMENtS

4 AOPA Contact PageHow to reach staff

6 At a Glance Statistics and O&P data

08 In the NewsResearch, updates, and company announcements

42 AOPA HeadlinesNews about AOPA initiatives, meetings, member benefits, and more

72 Jobs Opportunities for O&P professionals

77 Calendar Upcoming meetings and events

79 Ad Index

80 AOPA Answers Expert answers to your FAQs

28 Materials ScienceBy Deborah ConnTitanium, magnesium, advanced plastics, and composites have revolutionized the O&P industry, improving the function, comfort, and cosmesis of prostheses and orthoses.

20 Science Fiction No MoreBy Jill CuloraLast month, a ground-breaking study demonstrated how humans can control robotic arms to reach and grasp objects using only their brains. This research, along with other cutting-edge studies and new prosthetic designs, will lay the foundation for the development of prosthetic devices of the future.

IN THE NEWS

4 O&P AlmAnAc JUNE 2012

PUBLISHER Thomas F. Fise, JD

EdItORIAL MANAGEMENt Stratton Publishing & Marketing Inc.

AdvERtISING SALES M.J. Mrvica Associates Inc.

dESIGN & PROdUCtION Marinoff Design LLC

PRINtING Dartmouth Printing Company

OP& Almanac

Copyright 2012 American Orthotic and Prosthetic Association. All rights reserved. This publication may not be copied in part or in whole without written permission from the publisher. The opinions expressed by authors do not necessarily reflect the official views of AOPA, nor does the association necessarily endorse products shown in the Almanac. The Almanac is not responsible for returning any unsolicited materials. All letters, press releases, announcements, and articles submitted to the Almanac may be edited for space and content. The magazine is meant to provide accurate, authoritative information about the subject matter covered. It is provided and disseminated with the understanding that the publisher is not engaged in rendering legal or other professional services. If legal advice and/or expert assistance is required, a competent professional should be consulted.

BOARD OF DIREcTORS

OFFIcERS

President thomas v. diBello, CO, FAAOP, Dynamic O&P, a subsidiary of Hanger Orthopedic Group, Houston, TX

President-Elect tom Kirk, Phd, Hanger Orthopedic Group, Austin, TX

Vice President Anita Liberman-Lampear, MA, University of Michigan Orthotics and Prosthetics Center, Ann Arbor, MI

Treasurer James Weber, MBA, Prosthetic & Orthotic Care Inc., St. Louis, MO

Immediate Past President James A. Kaiser, CP, Scheck & Siress, Chicago, IL

Executive Director/Secretary thomas F. Fise, Jd, AOPA, Alexandria, VA

DIREcTORS

Kel M. Bergmann, CPO, SCOPe Orthotics and Prosthetics Inc., San Diego, CA

Michael Hamontree, OrPro Inc, Irvine, CA

Russell J. Hornfisher, MBA, MSOd, Becker Orthopedic Appliance Co., Troy, MI

Alfred E. Kritter, Jr., CPO, FAAOP, Hanger Prosthetics & Orthotics Inc., Savannah, GA

Eileen Levis, Orthologix LLC, Philadelphia, PA

Ron Manganiello, New England Orthotic & Prosthetic Systems LLC, Branford, CT

Mahesh Mansukhani, MBA Össur Americas, Aliso Viejo, CA

Michael Oros, CPO, Scheck & Siress, Chicago, IL

Frank vero, CPO, Mid-Florida Prosthetics & Orthotics, Ocala, FL

O&P HIStORY—A LOOK BACK IN tIME

AOPA CONTACT INFORMATION

330 John Carlyle St., Ste. 200, Alexandria, VA 22314AOPA Main Number: 571/431-0876 AOPA Fax: 571/431-0899www.AOPAnet.org

EXECUtIvE OFFICES

thomas F. Fise, Jd, executive director, 571/431-0802, [email protected]

don deBolt, chief operating officer, 571/431-0814, [email protected]

O&P ALMANAC

thomas F. Fise, Jd, publisher, 571/431-0802, [email protected]

Josephine Rossi, editor, 703/914-9200 x26, [email protected]

Catherine Marinoff, art director, 786/293-1577, [email protected]

dean Mather, advertising sales representative, 856/768-9360, [email protected]

Steven Rybicki, production manager, 571/431-0835, [email protected]

Stephen Custer, staff writer, 571/431-0876, [email protected]

Christine Umbrell, editorial/production associate, 703/914-9200 x33, [email protected]

AmERIcAn ORTHOTIc & PROSTHETIc ASSOcIATIOn (AOPA)

MEMBERSHIP ANd MEEtINGS

tina Moran, CMP, senior director of membership operations and meetings, 571/431-0808, [email protected]

Kelly O’Neill, manager of membership and meetings, 571/431-0852, [email protected]

Steven Rybicki, communications manager, 571/431-0835, [email protected]

Stephen Custer, coordinator, membership operations and meetings, 571/431-0876, [email protected]

AOPA Bookstore: 571/431-0865

GOvERNMENt AFFAIRS

Catherine Graf, Jd, director of regulatory affairs, 571/431-0807, [email protected]

devon Bernard, manager of reimbursement services, 571/431-0854, [email protected]

Joe Mcternan, director of coding and reimbursement services, education and programming, 571/431-0811, [email protected]

Reimbursement/Coding: 571/431-0833, www.LCodeSearch.com a

Get your fill at www.oandplibrary.org/op!A digital archive of issues

ranging from 1975 to 1988 of O&P Journal, predecessor

of the O&P Almanac.

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IN THE NEWS


Source: “Osseointegration Amputation Prostheses on the Upper Limb: Methods, Prosthetics, and Rehabilitation,” by Stewe Jonsson et al., Prosthetics and Orthotics International, June 2011.

6 months

8.3 yearsRatio of males to females who underwent upper-limb osseointegration procedures.

Percentage of upper-limb osseointegration patients whose amputations resulted from trauma.

Mean number of years between primary amputation and date of osseointegration implants for patients in this study.

Duration of healing period between the first and second surgeries necessary for the procedure.

31:6

86%

AT A GLANCE

Osseointegration Procedures by the NumbersBetween 1990 and April 2010, 37 upper-limb cases were treated with osseointegration procedures (eliminating the need for a socket) and fitted with prostheses for a study performed in Sweden. Patient follow-up indicates function and quality of life improve after osseointegration.

Number of main components in osseointegration implant system. (This includes a threaded titanium implant, a skin-penetrating cylindrical implant,

and a titanium screw.)3

Source: “Osseointegration Amputation Prostheses on the Upper Limb: Methods, Prosthetics, and Rehabilitation,” by Stewe Jonsson et al., Prosthetics and Orthotics International, June 2011.

2Number of surgical procedures needed for osseo-integration method. (During the first surgery, a titanium fixture is surgically attached to the skeleton, and the second surgery involves a skin-penetrating abutment to which a prosthesis is attached.)

types of Amputation for Upper-Limb Osseointegration Patients

Causes of Amputation for Upper-Limb Osseointegration Patients

transradial10

thumb10

transhumeral16

trauma32

tumor2

Congenital2

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IN THE NEWS

Elephant Steadies Her Gait With Orthopedic Shoe

IN THE NEWS


O&P Experts Meet for BOC Test Development

A group of subject matter experts met in Atlanta to author new questions, known as “items,” for clinical simulation examinations in orthotics and prosthetics and multiple-choice examinations in orthotics, prosthetics, orthotic fitting, and mastectomy fitting for the Board of Certification/Accreditation International (BOC). In addition to practicing BOC certificants, college professors and BOC-accredited facility represen-tatives comprised the group.

The item writers were led by a team of expert psychometricians from Applied Measurement Professionals Inc., a partner in BOC’s item-writing workshops.

Breakout sessions at the workshop resulted in the generation of new clinical simulation scenarios, as well as new questions for self-assessment examinations (SAEs). The groups also created additional multiple-choice items for four BOC certification exams. A large item bank of multiple-choice questions enables BOC to offer these exams year-round at testing facilities nationwide, allowing candidates to test when ready, without waiting for a limited-time exam window. BOC candidates receive instant scoring upon completion of their multiple-choice exams.

The new SAEs created as a result of recent test item development can be taken by BOC candidates at www.bocusa.org/SAE.

Snell Prosthetic & Orthotic Laboratory treated its largest patient ever when it fitted the elephant Jewell with a custom orthotic shoe designed to help the elephant walk with a steadier gait.

Jewell, a 60-year-old Asian elephant living at the Little Rock Zoo since spring of 2011, was having trouble walking on her front right leg. As an elephant of advanced age, Jewell’s joints have become less limber, making it more difficult for the 9,000-pound pachyderm to evenly distribute her weight on all four legs.

Keepers observed Jewell walking abnormally and wondered if there was a way to create a device for the animal that would help distribute her weight on her legs. Seeing various prototypes from other zoos around the country,

zoo staff contacted Snell to create a custom shoe for Jewell.

Snell’s team took measurements of Jewell’s feet and designed a prototype for Jewell’s front right foot. After a few additional modifications were made, the shoe was completed.

Zoo staff work with Jewell on wearing the shoe and have noticed a

change for the better in the way she walks. “The orthotic shoe provided by Snell has stabilized Jewell’s front foot and helped her to distribute her weight evenly. Keeper staff have noticed Jewell walking more, and any wear on her foot that was present before is disappearing,” says Joe Darcangelo, large hoof stock curator.

IN THE NEWS


Wendy Beattie, CPO, FAAOP, facility manager of Becker Orthopedic in Waterford, Michigan, is the 2012 recipient of the Clinical Commitment Award from The American Academy of Orthotists and Prosthetists. This award recog-nizes an orthotist or prosthetist who has quietly demonstrated a commitment to the field of orthotics and prosthetics and to improving the professional image of the profession to patients, co-workers, and colleagues.

West Virginia University sophomore Katherine Bomkamp, who developed a pain-free socket to help amputees, has been named a 2012 Newman Civic Fellow. See page 8 of the January issue of O&P Almanac for details about the device.

Amoena USA in Kennesaw, Georgia, has promoted Geri Bonnevier to national sales manager and Andrea Coomans to west regional manager.

The Board of Certification/Accreditation, International, has two new directors on its board: Rod Borkowski, general manager of Health Essentials, Costa Mesa, California, and Brad Watson, BOCPO, Clarksville Limb and Brace and Rehab Inc. Clarksville, Tennessee.

SPS has announced the additions of Eric Fuller and Bill DiNapoli to the SPS management team.

Daniel Strzempka, CPO, area practice manager for Hanger Clinic’s Sarasota, Florida, patient-care facility, and Kevin Carroll, MS, CP, FAAOP, vice president of prosthetics for Hanger Clinic, headquartered in Austin, have been selected to receive a Tribeca Film Festival Disruptive Innovation Award for their work to develop WintersGel, a prosthetic liner first developed for Winter, a tail-less dolphin at Clearwater Marine Aquarium, Florida.

IN THE NEWS

TRANSITIONS people in the news

First O&P School Opens in Philippines

The new Tan Yan Kee Building, home to the Philippine School of Prosthetics and Orthotics (PSPO) at the University of East Ramon Magsaysay Memorial Medical Center Inc. (UERMMMCI), Quezon City, opened in April. The school is the first of its kind in the Philippines, a country with 4.5 million people who have disabilities.

In October 2010, the Nippon Foundation and the U.K.-based

Cambodia Trust pledged to give a $7 million, 10-year grant for the PSPO curriculum through a memorandum of understanding with UERMMMCI. The PSPO will operate as part of the UERMMMCI College of Allied Rehabilitation Sciences and will be based on World Health Organization

guidelines and International Society of Prosthetics and Orthotics standards.

The first cohort of students is completing its first full year of O&P training.

ABC Announces Certified Assistant Exam for 2013

The American Board for Certification in

Orthotics, Prosthetics and Pedorthics Inc. (ABC) announced that effective Jan. 1,

2013, all candidates for the Certified Orthotic/

Prosthetic Assistant designation will need to meet the education and experience eligibility requirements of the current Pathway 2, as well as pass a discipline-specific, multiple-choice examination.

Candidates interested in the Certified Orthotic/Prosthetic Assistant credential should visit the ABC website to view the expiration dates of the pathways and to find applications and attestation forms.

Visit www.abcop.org/certification for more information.

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IN THE NEWS

TRANSITIONS BUsinesses in the news


The Amputee Coalition has been awarded a three-year grant from the Centers for Disease Control and Prevention for the support of its National Limb-Loss Resource Center.

The Challenged Athletes Foundation has announced the distri-bution of more than $1.3 million in grants through its Access for Athletes program. Grants were distributed to 1,102 athletes who have disabilities in 27 countries. The funding will pay for adaptive sports equipment (such as handcycles, sports chairs, and prosthetics), training and coaching, and competition expenses.

Hanger Orthopedic Group’s therapeutic solutions business unit, Accelerated Care Plus, has become the official supplier of advanced thera-peutic modalities to IMG Academies in Bradenton, Florida, a multisport training and education complex.

Hanger Orthopedic Group also has announced the completion of enrollment in its INSTRIDE investigational device exemption clinical trial studying the effectiveness of its WalkAide System in the rehabilitation of stroke survivors who have hemiplegia known as “drop foot.” The trial has enrolled 496 patients at 30 U.S. institutions.

The iWalk BiOM prosthetic ankle and the Niagara Prosthetics and Orthotics International field-adjustable Niagara Foot are among the 41 medical devices that have been selected as finalists in the 2012 Medical Design Excellence Awards.

The International Paralympic Committee (IPC) has launched the first official website of the Oceania Paralympic Committee, www.oceaniaparalympic.org. The website launch is part of IPC’s overall digital strategy to develop a greater online presence for its members over the coming years.

OPAF, the Orthotic & Prosthetic Activities Foundation, has welcomed Hanger Clinic, headquartered in Austin, as a 2012 Bronze-level sponsor.

Össur Asia, headquartered in Shanghai, China, has announced the opening of Össur Korea, Seoul. Össur technologies were introduced to Korea in the early 1990s by business partner Park Chung-Ha and his company Park Prosthetics & Orthotics, Seoul.

The U.S. Army Medical Research and Materiel Command, alongside the Office of Naval Research, Department of Veterans Affairs, and National Institutes of Health, is seeking applica-tions for grants as part of a Pentagon initiative. The Pentagon has launched a $75 million program to support experi-ments to heal combat injuries with regenerative medicine, with a specific focus on limb-salvage technologies and ways to treat trauma-induced damage to joints.

Obesity Contributes to Larger Portion of U.S. Health-Care Costs

Obesity now accounts for almost 21 percent of all U.S. health-care costs, more than twice the previous estimates, according to a study conducted by researchers at Cornell University.

The study, published in the January issue of the Journal of Health Economics, reports that an obese person incurs $2,741 more in medical costs than if that individual were not obese. That translates into $190.2 billion per year nationwide, or 20.6 percent of national health expenditures.

To find these estimates, the researchers approximated the effect of obesity on medical expenses by treating the heritable component of weight as a natural experiment. Previous studies have reported the differences in medical expenses between heavier and lighter people, but this can be misleading because it does not differentiate between obese and nonobese people.

“For example, I could have injured my back at work,

and that may have led me to gain weight,” says John Cawley, PhD, a professor of policy analysis and management of economics at Cornell and lead author of the study. “The injury could lead to a lot of health-care costs that are due to my back, not my obesity.”

The research provides evidence that could influence policymakers when making decisions about funding obesity prevention programs.

“Historically we’ve been underestimating the benefit of preventing and reducing obesity,” Cawley says. “Obesity raises the risk of cancer, stroke, heart attack, and diabetes. For any type of surgery, there are complications with anesthesia and with healing. Obesity raises the costs of treating almost any medical condition. It adds up very quickly.”

IN THE NEWS


College Student Builds Prosthetic Arm From LEGOs

COrrECTiONIn the April issue of the O&P Almanac, Ken

Cornell, CO, was quoted incorrectly in the article “The Outsourcing Decision” by Anya Martin. The paragraph at the bottom of the middle column on page 30 should have read as follows:

Because practitioners work directly with techni-cians and can show them exactly what they are looking for, Cornell says, the practice is more likely to deliver a more individualized orthosis for each condition. As a result, practitioners can focus more on the function of the brace than on the fit, and that kind of hands-on customization is unlikely with a lab that is hundreds or thousands of miles away.

We regret the error.

A University of North Carolina—Chapel Hill student, Max Shepherd, has constructed an operational above-elbow prosthetic arm using only LEGO bricks. Shepherd’s model is surprisingly similar to a human arm.

The LEGO brick arm is capable of a free range of motion from the elbow to the fingers identical to that of a human being, including independent finger control and dynamic movement of the thumb and wrist.

“The main purpose of this project was to accurately mimic the full range of motion of a normal human arm and hand,” explains Shepherd. “The secondary goal was to maximize speed and power, yet maintain a consistent ratio between the two for demonstration purposes.”

The model is not intended to be an actual prosthetic surgical replacement. The strength in the bricks limits the capabilities of lifting and grasping to small objects such as a water bottle and an empty roll of tape.

View a video of the LEGO arm at www.youtube.com/user/sumthinelse5790.

Model prosthetic arm made entirely of LEGOs. Hand movements and wrist abduc-tion/adduction are LEGO pneumatics. Wrist pronation/supination, wrist flexion/extension, and elbow flexion are LEGO motors.

OP& Almanac

Next Month:2012 Olympics,

Sports & Rehabilitation

Pho

tos:

Max

She

phe

rd

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n Reimbursement Page

By Joseph McTernan, AOPA government affairs department

A successful O&P practice cannot rely only on excellent clinical service; it also has

to be run efficiently to maximize its potential for profit. While an O&P facility faces many challenges in its daily operations, the ability to quickly and accurately bill and collect reimbursement for the services it provides is an especially important one that can mean the difference between a profitable business and a nonprofitable business. The strategies presented on the following pages will help improve your company’s ability to not only collect reimbursement but also minimize the loss of reimbursement due to improper collection activities.

The most basic principle of any business model is to maximize profit while containing costs. It does not require an MBA to understand that

basic business strategy. Companies operating at a loss can rarely afford to continue to exist. When you consider the traditional mom-and-pop nature of the O&P profession, this principle carries even more weight. Small businesses tend to be more heavily affected by ebbs and flows in cash flow than larger businesses. The single most important asset for any business is liquid cash. It is what allows you to pay your staff, purchase your inventory, create new opportunities, and operate your business effectively on a daily basis. Without reasonable cash flow, even the most profitable business can quickly find itself in dangerous territory.

Many businesses record revenue from a sale upon the exchange of merchandise or services. While that practice may paint an attractive picture

Making the Most of Accounts ReceivablesImprove your collection activities to minimize reimbursement losses

on paper, the benefits of the revenue cannot be realized until payment has actually been collected. Revenue that has been recorded but not collected is defined as accounts receivable (AR). The ability to collect AR efficiently and thoroughly is a sign of a healthy business. Once a debt is collected, the revenue can go to work for you instead of for the debtor. While a certain amount of outstanding AR has to be expected, the ability to maintain low AR balances is important to the success of your business.

Collect What You Can First“Time is money”: This saying comes

to mind when developing successful AR collection strategies. The longer it takes you or your staff to collect a debt, the less it is worth. One strategy that may help reduce your AR balance is to identify the easy collections and make them a priority. Although this approach may require the investment of some front-end organization of outstanding debts, it may actually pay dividends in the end by helping you and your staff members to spend less time chasing bad debt and more time collecting real cash. While collecting a single large debt may create a big splash, collecting many



smaller debts may ultimately result in better daily cash flow.

Another strategy for decreasing AR is to always attempt to collect coinsurance amounts and deductibles at the time the device is delivered. Medicare regulations allow for this, and it is an opportunity to collect the debt before it gets to your AR balance. It may not always be realistic to collect the full coinsurance, especially for services that result in a high coinsurance for the patient, but you may want to encourage the patient to pay what he or she can at the time of delivery. Any amount that you receive effectively reduces what you will have to collect later.

The same strategy applies for nonassigned Medicare claims. If you choose to not accept assignment, the patient is financially liable to pay you as much as your full usual and customary charge at the time of delivery. Similar to coinsurance and deductibles, collection of all or some of the balance due from the patient at the time of delivery increases your cash flow and decreases your AR.

think BigWhile sometimes it’s better to have

several small successes when collecting debts, if the big one is out there, by all means go and get that debt paid. Once you evaluate your outstanding AR and organize the debts according to how easy they will be to collect, start with the largest amount. Once again, because time is money, the overall goal is to collect the largest amount of money in the least amount of time. If you have the luxury of having more than one staff member working on collection of outstanding AR, use your best talent to collect the higher debts. Their advanced experience and unique skills should be used to help maximize your returns.

Cut Your LossesNo matter how well a claim looks

going into the system, sometimes there are circumstances, either seen or unseen, that result in what is known as “bad debt.” That type of AR is virtually uncollectable, and leaving it on your books serves no

real purpose other than to increase your outstanding AR balance. A good example of bad debt occurs when you provide a service to a Medicare patient who is denied as not medically necessary because of a lack of a valid prescription. There is little to no hope that Medicare will pay the claim because mandatory documentation requirements were not met. Without a signed Advanced Beneficiary Notice on file, the patient cannot be held liable for payment. Because this scenario creates a no-win situation for the provider, it may be in the company’s best interest to write off or cancel the debt. Although that won’t improve your cash flow, it does effectively reduce your outstanding AR and allows your staff members to refocus their energy on collectable debt.

Offer CreditThe best time to collect coinsurance

and deductibles is when the completed device is delivered to the patient. If circumstances keep a patient from


paying his or her full share of the item’s cost, you typically can take one of three actions:•You can document that the patient

is experiencing financial hardship and write off the claim immediately.

•You can agree to a payment plan where the patient will pay his or her share of the cost directly to you over a predetermined period of time.

•You can explore alternate sources of financial help for the patient. Credit card companies will process

patient coinsurance and deductible payments as retail sales. The difference is that the credit card company has essentially purchased that debt from you and the debt now resides in its AR account, not yours. Payment of the debt is now a negotiation between the patient and the bank that issued the credit card. The only fee you are respon-sible for is the small per-transaction fee credit card companies charge their merchant account holders.

In addition to traditional credit cards, there are companies that specialize in financing medical debts. Those companies often offer attractive interest rates to patients for the purpose of financing medical expenses only. AOPA does not endorse any particular company that provides this service, but such companies are easy to find on the Internet and may actually provide your company with an opportunity to increase your market share by offering multiple payment options to potential patients.

Build Relationships With Payers

The value of a friendly relationship goes a long way in the world of AR collection. Having a contact above the general customer service call center level is often crucial to collecting AR that involves complex billing issues. The call center will usually only provide you with the status of a claim and not much more, which can lead to lengthy and often unnecessary delays in claim payment.

If you have a professional relationship with an insurance company employee—perhaps a supervisor or someone working in a specialty department (such as accounting)—you may be able to obtain important details about specific claims. Such relationships can sometimes mean the difference between a successful collection and an unsuccessful one. If you attempt to build those relationships before there is an issue, when an issue does arrive you will have an inside track to resolution.

One way to build those relation-ships is to determine if a payer has a provider education team; those teams consist of experienced, specialized provider service representatives who are focused on communicating with the provider community. Even if they cannot assist you in solving a specific problem, they can usually direct you to someone who can. Also, if you have the opportunity to speak to a supervisor, document his or her name and ask if you may contact him or her in the future if you need additional assis-tance. If you are polite, professional, and respectful, you will find that people are much more willing to help you resolve your issue.

Outside ResourcesMany collection agencies make

their highest number of calls between the hours of 6 and 8 p.m. Why is that?

Because collection agencies know their best chance to reach somebody at home is during the traditional dinner hour. They know that because they are professional organizations that make their living collecting debt that has proven difficult to collect. Most collection agencies offer useful services in addition to recovering hard-to-collect debts; some agencies will offer to purchase some or all of your company’s outstanding AR for a percentage of what it is worth on paper.

For example, if your company has $10,000 of outstanding AR, a collection agency may offer you $8,000 to purchase that debt. If it is successful in collecting the full amount, the agency will receive a $2,000 profit. While the advantage to the collection agency is clear, the advantage to your company is twofold. First, you receive immediate cash without having to spend valuable staff time and energy chasing paper trails. Second, the collection agency now assumes the risk associated with collecting the debt and only realizes a profit if it collects more than what it paid you for the AR.

Many O&P companies feel the benefits of using outside resources to collect AR outweigh the cost. Ultimately, deciding whether to use a collection agency is just another option you should consider when figuring out how best to collect your AR.

The management of cash flow is crucial to the success of any business venture, including the management of an orthotic and prosthetic practice. The strategies discussed here represent only a few possible ways to successfully manage your company’s AR balances. There is no right or wrong answer to the question of how to best manage your AR. a

Joe McTernan is AOPA’s director of coding and reimbursement services. Reach him at [email protected].

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ABC Accreditation 12-3-10.qrk_Layout 1 12/3/10 11:51 AM Page 1


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That’s why I care. That’s why I chose ABC for my facility accreditation.ABC—The gold standard. I don’t want anything less, why should you?

ABC Accreditation 12-3-10.qrk_Layout 1 12/3/10 11:51 AM Page 1


Science Fiction No MoreBreAkthrOUgh DISCOVerY IN NeUrOteChNOlOgY hAS

reSeArCherS rethINkINg the BrAIN-PrOStheSIS CONNeCtION


COVEr STOrY

fter Luke Skywalker’s arm is severed in a duel with Darth Vader in The Empire Strikes Back, he visits the medical center on Star Cruiser where an adroid installs a new limb. Luke wriggles his fingers, makes a fist, and the medical droid pricks Luke’s hand.

“Ow!,” says Luke. If only replacing body parts was as simple as that scene would

suggest—pure fiction born from the vivid imaginations of movie script-writers. But fast-forward 30-some years, and real-life researchers are making significant advances in neurotechnology—interfacing brain activity with sophisticated prostheses—and bringing us light-years closer to turning that famous Star Wars scene into reality.

In a ground-breaking study released last month, researchers have successfully demonstrated for the first time how humans can precisely control a robotic arm to reach and grasp objects in three-dimensional space using only their brains. The study, called BrainGate2 (www.braingate2.org), is a collaborative effort from researchers at the Department of Veterans Affairs (VA), Brown University, Massachusetts General Hospital, Harvard Medical School, and the German Aerospace Center.

“It’s extremely encouraging. It’s very clear that we have laid a foundation to move towards many kinds of devices that can be used to physically fix the nervous system when it’s damaged. And I think this is going to continue on, and it will lead to solutions that we haven’t thought of yet,” says Professor John Donoghue, senior research scientist at the VA in Providence, professor of neuroscience and engineering at Brown University, and director of Brown’s Institute for Brain Science.

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Leigh Hochberg, MD, PhD


Using her thoughts, Cathy Hutchinson is able to command a robotic arm to grasp and move a bottle toward her mouth, so she can drink coffee from the bottle through a straw.

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In the study, Cathy Hutchinson, 58, of Massachusetts (referred to as “S3” in the study) and 66-year-old Robert Veillette of Connecticut, both tetra-plegics and unable to speak because of a brainstem stroke years earlier, used brain activity to control two different robotic arms, one developed by the DLR Institute of Robotics and Mechatronics and the other by DEKA Research and Development Corp. The study uses an investigation BrainGate system, initially developed at Brown University, where a baby aspirin-sized microelectrode array device with a grid of 96 tiny electrodes is implanted in the motor cortex—a part of the brain involved in voluntary movement. The electrodes are close enough to individual neurons to record neural activity associated with intended movement. An external computer translates the pattern of impulses across a population of neurons into commands to operate assistive devices.

“We have much more work to do, but the encouraging progress of this research is demonstrated not only in the reach and grasp data, but even more so in S3’s smile when she served herself coffee of her own volition for

the first time in almost 15 years,” says Leigh Hochberg, MD, PhD, a neuro-engineer and neurologist who holds appointments at the VA, Brown, Mass General, and Harvard.

New EnlightenmentResearchers working in the neuro-

technology field also have discovered that the traditional understanding of brain function is simply incorrect. For example, instead of different parts of the brain controlling specific parts of the body, they have found there are zones responsible for controlling many parts.

“Any one zone has signals for your fingers, your wrists, your elbow, your shoulder, and controls the whole arm. And our work, both pre-clinical trials and now in the humans, strongly indicates the fact that this is the case,” says Donoghue. “So, when we put one small sensor into the brain, we can get signals sufficient to have instructions about how you want to move your fingers, your wrist, your elbow, and shoulder all at once.”

This new development is encour-aging news for people who have suffered neurologic disorders, injury,

or limb loss, as research has already proven that in each of those cases the brain is still working while the limbs are not. “They all have a brain that is working fine,” says Donoghue,

“but they have nothing to control because either their pathway is broken or there is nothing to control, which is the case with an amputee.” Neurotechnology aims to replace that missing pathway.

In terms of barriers to bringing this product to market, Donoghue points to a penny-sized plug in the back of the head that has to be connected by a technician. “We are working on a better device, and the project is led by Professor Arto Nurmikko at Brown, and he is developing something that’s about the size as a large gum eraser that will go under the skin and will be able to process and transmit all the information from our sensor wirelessly through the skin,” says Donoghue.

Meanwhile, at the University of Pittsburgh, researchers studying monkeys and the highest performing prosthetic arm ever made have obtained seven degrees of freedom using neuroprosthetic control from a 100-sensor neural interface.

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“We have shown that monkeys can control this arm, so it looks pretty much like a natural arm being controlled,” says Andrew Schwartz, professor of neurobiology at Pitt.

“Now we’re working on having the monkeys learn to shape the hand by moving the fingers in different ways.”

The Modular Prosthetic Limb arm, or MPL, used in the study was developed by John Hopkins University Applied Physics Laboratory and is capable of reaching 25 degrees of freedom. A biological arm has about 30 degrees of freedom, depending on how the fingers are counted, says Schwartz.

The Pitt study is funded by the Defense Advanced Research Projects Agency (DARPA). An upcoming DARPA RP3 project will see human patients implanted with the same technology used by Schwartz’s monkeys. Tetraplegic patients will be using the 100-sensor neural interface to operate the MPL arm. The first patient will have the current technology; a second patient will have the addition of having sensory feedback to the brain; and a third patient will have wireless telemetry rather than plugs coming out of his or her head.

“It’s a huge advance. If you look at other people trying to obtain any kind of prosthetic control, hardly anybody can get up to three degrees of freedom,” says Schwartz. “So, we’re up to seven, and we are rapidly moving toward 10 or 11. When we get to 10 or 11, you’ll be able to shape a hand and then you can do many tasks of daily living. Even with seven degrees of freedom, you can do a lot of daily living tasks. Our quest is so we can get to dexterous tasks, which sort of make us uniquely human—buttoning buttons, pulling zippers—we’d like to do that in a way that would be as natural as using your own hand.”

the Great UnknownWhile neuroscientists rewrite the

guide to brain function, they also are discovering how little they under-stand about how hand movements are represented in the brain.

“Hand shape really hasn’t been worked out at all yet—how you represent hand shape with neural activity,” says Schwartz. “There’s also the problem that normally when we do this, there are millions and billions of neurons that are active at the same time, and we just have a small population of maybe a couple hundred neurons at best. And because we have this limited sample, it means our ability to control these things simultaneously is rather limited.”

The brain has billions of neurons, and each neuron doesn’t code for a single action; it codes for multiple ones. “If you only want to close your hand without bending the wrist, there are no neurons that will only close the hand, they all do something else. So, you have to have other neurons that will counteract the unwanted contri-bution that those neurons make to your movement,” Schwartz explains.

To do so, the researchers implanted electrodes to record the individual neurons, which communicate via little bursts of electricity called “action potentials.” Researchers count how many action potentials each neuron fires and then translates that fire rate into a desired movement. “It’s… a puzzle,” says Schwartz, “we don’t necessarily know what we are looking for.”

Schwartz explains that his team is able to write equations that are continuous so there are no gaps between movement categories. “Our quest is to try to write the proper equations, and those are really models of how we think the brain works. The more aggregate our models, the better we’re able to make predictions about what the brain is trying to do.

“This idea of looking at popula-tions of neurons and trying to get the collective actions of groups of neurons is in its infancy,” Schwartz continues.

“We really haven’t developed many mathematical tools for looking at that, and we’re applying in our research some of the most simplistic models there are out there to try to capture this population activity. And we’re

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able to get a pretty decent level of performance just doing that. As we push the limits of what we’re able to control to make it more and more complex, it’s not clear that these models are going to be sufficient.”

Ongoing ExplorationResearchers’ desire to bring to

patients the absolute best technology to make prosthetic limbs as close as possible to the natural human experience continues to push other similar efforts both in the United States and abroad.

Neuroscientists at the Center for Neural Engineering and Prostheses (CNEP) at the University of California, Berkeley, and the Champalimaud Center for the Unknown in Portugal were published in the journal Nature last March for demonstrating that the brain is more flexible and trainable than previously thought. Their research will open doors to the development of thought-controlled prosthetic devices to help people with spinal cord injuries, amputations, and other impairments.

Through a process called “plasticity,” parts of the brain can be trained to do something they normally do not, says Jose Carmena, associate professor of electrical engineering, cognitive science, and neuro-science and co-director of the UC

Berkeley-UCSF CNEP. The same brain circuits employed in the learning of motor skills, such as riding a bike or driving a car, can be used to master purely mental tasks, even arbitrary ones. “Most brain-machine interface studies have been done in healthy, able-bodied animals,” says Carmena.

“What our study shows is that neuro-prosthetic control is possible, even if physical movement is not involved.”

In late 2011, Duke University announced that it had demonstrated a two-way interaction between a primate brain and a virtual body. Study leader Miguel Nicolelis, MD, PhD, professor of neurobiology at Duke and co-director of the Duke Center for Neuroengineering, said his group had trained two monkeys to move an avatar hand and identify textures on virtual objects. “We are hoping that this research can lead to people that suffer severe lesions of the spinal cord—and thus make the patients severely paralyzed from the level of that lesion down—that they will be able to use this brain machine, brain interface, to control a whole-body robotic vest, an exoskeleton, that will restore full-body mobility to these patients, and also restore the ability to sense what they encounter as they move around in the world.”

The research is part of an interna-tional consortium between Duke, the Technical University of Munich, the Polytechnic School in Lausanne, and the Natal Institute of Neuroscience in Brazil. “We hope to basically put all this technology together to create a whole-body prosthetic device that may allow quadriplegic and paraplegic patients to regain mobility and the sense of touch as they interact with a brain machine, brain interface,” Nicolelis said in a university statement.

Meanwhile, engineering researchers at the University of Michigan, Rice University, Drexel University, and the University of Maryland were awarded a $1.2 million grant last year from National Science Foundation’s Human-Centered Computing program for a four-year

project to design a prosthetic arm that amputees can control directly with their brains and that will allow them to feel what they touch.

The team plans to incorporate technology that feeds both tactile information from prosthetic fingertips and grasping-force information from a prosthetic hand to the brain through a robotic exoskeleton and touchpads that vibrate, stretch, and squeeze the skin where the prosthesis attaches to the body. The process is noninvasive, as the subjects wear a cap to test the technology, rather than having surgical implants.

“Other research groups are working on drawing signals more directly from the nerves of the brain, but they are finding that this approach is fraught with technical hurdles. What we’re doing is a lot closer to being realized and commercialized,” Brent Gillespie, U-M associate professor of mechanical engineering, said in a statement.

As a genre, science fiction is as much about a prediction or vision of the future as it is about humans in the present day. The restoration of Luke Skywalker’s arm was a graphic and prescient prediction of the future—a future that may be closer than once thought due to the imagination, research, and collaboration of a group of professionals dedicated to improving mobility and quality of life for people around the world. a

Jill Culora is a contributing writer to O&P Almanac. Reach her at [email protected].

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By DEBORAH CONN

aterials used in the fabrication of orthotic and prosthetic devices have

changed in astonishing ways since the early days of wood and leather. Titanium, magnesium, advanced plastics, composites, and other new substances have revolutionized the industry, creating more functional, comfortable, and cosmetically appealing devices than ever before.

For the most part, O&P relies on technological advances in other fields—such as the aerospace industry—to feed its materials needs. “We’re a niche industry, so making something specific to O&P is not cost-effective in the market-place,” explains Brad Mattear, CFO, national key accounts manager for Cascade Orthopedic Supply, based in Chico, California. Instead, savvy manufacturers and suppliers often repurpose existing materials for use in O&P components.

Polyurethane Resins

Polyurethane resins are an example of a material that has been available for years, but manufacturers have only recently turned to them for use in O&P components. The material is rugged, sweat- and waterproof, and—most important—flexible when cured.

Ottobock introduced Polytol, a polyure-thane-based three-component lamination resin, four years ago for use in prosthetic sockets. Polytol allows technicians to create customized flexible areas in the socket or a completely flexible inner socket, according to Scott Weber, senior market manager for Minneapolis-based Ottobock HealthCare.

M

A LOOk AT SOME Of THE SUbSTANCES

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“That flexibility is particularly important in devices like transfemoral sockets, where flexibility in the posterior section allows the amputee to sit more comfortably, as well as offers the flexibility to allow some muscle movement within the socket,” says Weber.

Ottobock also uses Polytol in fabricating hip sockets, because the adhesive quality of the material creates a good connection between the wearer and the prosthesis. Polytol is a replacement for standard thermo plastic liners used in hip sockets.

Freedom Fabrication, based in Havana, Florida, also began using polyurethane resins several years ago. The company wanted to increase the flexibility of its components to improve their interface with people, according to CEO Anthony Wickman, CTPO.

“Most components need a combination of rigidity to hold the mechanical components where they need to be and flexibility to connect with the wearer.”

Freedom Fabrication uses polyurethane resins to create its 2nd Ankle, an ankle gauntlet with artificial tendons that

provide rigid support where it is needed. The rest of the shell, however, remains flexible so the orthosis can


focus on the pathology without inter-fering with other parts of the gait cycle.

“Too often, we can fix a problem, but the solution causes collateral damage downstream,” says Wickman.

“The flexibility of this material minimizes collateral damage because it does not press on other parts of the foot and ankle.”

Low-temperature thermoplastic

Another repurposed O&P material is 3D-Lite, a low-temperature thermo-plastic textile produced by Allard USA, based in Rockaway, New Jersey. It is manufactured in Belgium by a company that specializes in chemical polymers used in the aeronautical industry, including the honeycomb structure used widely in the aircraft frames. 3D-Lite is made from an open-weave polyester material impregnated

with a biodegradable resin.Other low-temperature thermo-

plastics can become harmful when overheated, says Jackie Valdez, CO, national product manager for 3D-Lite and X-Lite materials at Allard USA.

“3D-Lite is nontoxic and easy for practi-tioners to use,” she says.

Uses include fracture bracing, lumbar sacral orthoses, thoracic lumbar sacral orthoses, hand braces, cosmetic covers, and rigid removable dressings. The material is not suitable for weight-bearing devices.

3D-Lite is ventilated, so it is breathable, and orthotists can use a heat gun or hot water bath to mold devices directly on the patient, without needing to create a cast. That convenient molding option allows practitioners to fit patients with a definitive orthosis in the hospital or at bedside.

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“3D-Lite is an ideal solution for facilities that service trauma centers,” says Allard USA General Manager Carol Hiemstra-Paez. “The doctor wants to get the patient out of the hospital right away, and no one has to wait for casting and fabricating.”

Another benefit of the material is that it is remoldable, so if a patient has a contracture, loses weight, or changes in any way, the practitioner can heat the brace and completely remold it.

“The material easily picks up on a patient’s bony abnormalities,” says Hiemstra-Paez. “When casting molds, we often have to guess where the buildup might be, and it’s a hit or miss proposition. With 3D-Lite, there is no guesswork.”

layer of this product on the outside of the socket and then grind out the inside,” Mattson says.

“The adhesive will not sag or drip, so practitioners and techs can use it in vertical situations,” he adds. “It really lends itself to working with patients in the fitting room.”

Mattson estimates that the +PLUSeries adhesives can cut 90 percent of the processing time for devices compared to using a traditional sealing resin, as well as eliminate many return patient visits, resulting in significant cost savings.

Fabtech Systems’ commitment to safety extends to developing other products as well, including nontoxic wipes designed to replace acetone and other toxic solvents in the lab. The biodegradable formula in +PLUSeries Solvent Replacement Wipes can remove dirt, paint, oil, epoxy and polyester resins, adhesives, grease, tar, glue, and many other materials without exposure to chemicals.

the New Kid on the Block Perhaps the newest material created

specifically for O&P is ProComp, a carbon-infused polypropylene prepreg composite created by Gary Bedard, CO, FAAOP. Bedard secured a utility patent for the material last January and will formally introduce it to the O&P community at the AOPA 2012 National Assembly in Boston, September 6-9.

Bedard developed ProComp as a way to increase the performance strength of sheet materials for fabricating O&P devices. He explains,

“Polypropylene is the ubiquitous sheet material for the fabrication of lower-extremity orthoses, and it has some application as socket material in prosthetics as well. Polypropylene is relatively stiff and has high-impact strength. It’s relatively easy to process via vacuum thermoforming, inexpensive, compatible with post delivery thermal recontouring for fit and comfort issues, and it has 40-plus years of successful clinical history.

Problem-Solving Materials

While adopting or adapting materials from other industries may be more common, some O&P technicians and suppliers have invested the time and money to create new materials, often because they felt strongly about solving a particular problem.

A poisoning incident early in Greg Mattson’s career sparked his push to reduce or eliminate exposure to toxins in O&P labs. Mattson, president and CEO of Fabtech Systems LLC, in Everett, Washington, worked with a chemist to develop a new, safer struc-tural urethane adhesive: +PLUSeries Adhesive. Fabtech’s product replaces traditional two-part filling resins, which expose users to potentially toxic or carcinogenic substances and fumes.

In addition to eliminating off-gassing, +PLUSeries adhesives can tolerate moisture better than other urethanes, are freeze-and-thaw stable, and have a two-year shelf life, he notes.

Technicians use a static mixer gun to dispense the adhesive, which is available in a range of working times, from 25 to 90 seconds. Its uses include bonding and repairing plastics, composites, aluminum, steel, plaster, and other materials used in the O&P manufacturing process.

“Because of its strength, if you need to relieve a bony prominence and there’s not enough material in the socket to grind it out, you can add a

infant TLSO (thoracolumbosacral) orthosis, used to correct scoliosis.

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The downside is the lack of ultimate performance strength we have gained through the use of thermoset carbon laminations and prepreg composites.”

Unfortunately, the stronger laminates and prepreg composites (in which structural fibers, such as carbon, are impregnated with resins and cured to the shape of the positive model, usually in an autoclave) are far more expensive than thermoplastic sheet materials.

Bedard began searching for an alter-native process for producing thermoset laminated knee braces back in 1988 and, he says, “it has been a personal project ever since.”

His design uses a propriety process to insert discon-tinuous carbon fiber into the core of a polypropylene sheet.

“The fibers are on average three-quarters inch in length and are arranged into a three-dimensional matrix that forms discrete layers in the core of the laminate for an ‘I-beam’ effect,” he explains. “The fiber

in the core of the laminate is blocked from the surface to prevent any skin contact issues.”

The fibers increase the sag strength of the laminate at melt temperature, allowing for a more controlled transfer of the sheet from the oven tray to the positive clinical model, resulting in improved wall thickness in the final product. The material has practically no shrinkage or warpage, and it is about 30 percent stiffer than polypropylene.

Both laboratory and clinical tests are in progress, and Bedard hopes the outcomes will be in place by September, when he introduces ProComp.

A national distributor will sell

ProComp as a sheet material, which is covered by current CMS reimbursement guidelines, and Bedard expects practitioners and technicians to make their own discoveries as they work with it.

“Since it is a new material with its own inherent physical characteristics, there will be a period of time where practitioners discover its ultimate advantages as well as failures in the wide spectrum of designs that have been produced in the 45-year history of polypropylene usages,” he says. “I’m sure there will be some unexpected discoveries that will benefit our patients.”

For Bedard, one of the most grati-fying aspects of his new composite is its “home-grown” nature. He says,

“One of my longtime mentors in the field, Marty Carlson, CPO, said, ‘We finally have a material we can call our own.’” a

Deborah Conn is a contributing writer to O&P Almanac. Reach her at [email protected].


n Ask the Expert

By Joseph McTernan, AOPA government affairs department

Q: Hospitals continue to refuse to pay for O&P services

that are ordered for their Medicare inpatients. Is it okay to bill those items directly to the DME MAC?

A: When a Medicare beneficiary is in a Medicare Part A covered

inpatient stay, the hospital is paid “prospectively” to provide all medically necessary care for that patient. In the scenario described above, the hospital has full responsibility to provide medically necessary O&P care through its own resources or through arrangements with a vendor. While the hospital does have some authority to determine what services are medically necessary, if orthotics and/or prosthetics are part of the plan of care for the patient, the hospital is responsible to provide that service.

Failure to do so is potentially a violation of the hospital’s provider agreement with Medicare.

Q: Hospital administrators are constantly asking us to bill

the DME MACs under the provisions of the “two-day rule.” What is it?

A: The two-day rule was never intended to be used as a

reimbursement strategy by hospitals that do not want to pay for medically necessary care, including orthotics and prosthetics. The sole purpose of the two-day rule is to allow for the delivery of items and services that are required immediately upon discharge from the hospital. By allowing for delivery of the item during the last two days of the inpatient stay, the item is guaranteed to be available for use

the AOPA government relations staff continue to receive many questions regarding who is responsible for payment when an orthosis or prosthesis is delivered somewhere other than in the O&P facility. this month’s Ask The Expert will provide answers to some of the more common questions AOPA receives on this topic.

immediately after discharge. Originally designed to allow oxygen providers time to ensure the transition from a hospital-delivered oxygen supply to a portable or home-based oxygen supply, the two-day rule has been manipulated into a strategy that is used to avoid the hospital’s responsibility to pay for medically necessary inpatient services. Any request to provide O&P services under the two-day rule should be reviewed with increased scrutiny to make sure it is being used as intended and not as a workaround of the Medicare payment rules.

Q: What about rehab hospitals? Are the rules different?

A: While rehabilitation hospitals are paid under a separate

Prospective Payment System (PPS) than acute hospitals, the rules regarding the rehab hospital’s responsibility to provide or pay for medically necessary care remain exactly the same as they are for acute care hospitals. From the O&P provider perspective, the same payment rules that apply to acute care hospitals also apply to rehab hospitals.

Billing Bluesdecoding the mysteries of inpatient deliveries

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Q: What about skilled nursing facilities (SNFs)?

A: For O&P services delivered to a patient in an SNF, the payment

rules are different. Specifically, there is an exemption for most prosthetic services under the SNF that allows the provider to bill the DME MAC directly for prosthetic services that are delivered to a patient in a Medicare Part A covered SNF stay. A list of specific HCPCS codes that are exempt may be found by following this link and clicking on “file 1”: www.cms.gov/Medicare/Billing/SNFConsolidatedBilling/2012Update.html. If an L Code is on the exempt list, it may be billed directly to the DME MAC. If it is not on the list, it must be paid for or provided by the SNF.

SNFs present another challenge in that Medicare patients are much more likely to exhaust their Medicare Part A SNF benefit than their hospital benefit. If a patient exhausts or no longer qualifies for Part A coverage of his or her SNF stay, any O&P services may be billed directly to the DME MAC. It is very difficult to confidently determine a patient’s Medicare Part A status independently. It is always best to confirm, in writing, that an SNF patient does not have Medicare Part A coverage available before agreeing to bill the DME MAC for any O&P service. That confir-mation should be obtained from the facility business office as it will be best equipped to provide you with accurate information.

Q: Can I deliver an O&P item to a hospital or SNF on the day

of discharge and bill the DME MAC?

A: Yes, provided that the patient is being discharged to a

location that qualifies as his or her home, and not to another inpatient facility. Medicare PPS rules provide payment to an inpatient facility on the day of admission but not on the day of discharge. Because the discharge date is not considered an inpatient day for benefits purposes, anything delivered

to the facility on the actual day of discharge is considered a Medicare Part B service and is billable to the DME MAC.

Q: If a doctor orders an orthosis or prosthesis during an

inpatient stay and I provide it, can the facility refuse to pay me?

A: Unfortunately, yes. Because the facility has the

responsibility to provide all medically necessary care during a Medicare Part A covered stay, it may choose the vendor that provides the care. If a physician provides you with an order and you provide the item without authorization from the facility, the

facility may not be obligated to pay you. This is not a Medicare issue per se; it’s more of a contractual issue. Because the facility is ultimately responsible for providing the care, it may decide who it wants to provide that care. While there may be legal precedents in some states that would require the facility to pay for the service, as a general rule, the hospital has the right to decide who it selects as its vendors and business partners.

While the scenarios discussed above only scratch the surface of the mysteries of inpatient billing, they represent some of the questions that we receive on a regular basis at AOPA. We look forward to continuing to support and educate our members and encourage you to keep presenting the questions that challenge you on a daily basis. a

Joe McTernan is AOPA’s director of coding and reimbursement services. Reach him at [email protected].

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n Facility Spotlight

You might expect a story behind the unusual name of Mary Free Bed Rehabilitation Hospital,

and you’d be right. In the 1890s, a group of women in

Grand Rapids, Michigan, believed that indigent patients had a right to medical care and began a fundraising campaign to support a “free bed.” At the time, Mary was a common name, so the theme of the effort was to solicit money from anyone named Mary or anyone who knew someone named Mary, which covered just about everyone. “Mary’s Free Bed” developed into a hospital, and eventually the name was shortened.

In its early years, the facility focused on polio cases, but with the cure of that disease in the 1950s, Mary Free Bed became one of the earliest hospitals to specialize in rehabilitation.

then and NowToday, the facility has 80 beds

and a multi-building campus that includes the main hospital; a profes-sional services building for outpatient activities; the Mary Ives Hunting

Center, which houses a computerized motion analysis center, one of only 50 in the United States; an O&P lab; and a Rehab Technology Center. The facility also offers an inn for visiting families.

Mary Free Bed has the oldest orthotics residency program in the country, as well as the oldest child amputee clinic. Originally known as the Mary Free Bed Brace and Corset Shop, the hospital’s O&P division now has 90 employees and represents about 13 percent of the facility’s services.

In addition to orthotics and prosthetics, Mary Free Bed provides assistive technologies, which CEO Kent Riddle describes as “all things behind helping a patient regain abilities through the use of technology.

“We customize technology for each patient,” he says, whether that patient is a “quadriplegic who needs to move her chair by laser or a paraplegic pianist who wants to use the pedals.”

A fourth service line, called Orthoseat, customizes wheelchair seating for patients. “We recently developed a wheelchair and bed for conjoined twins,” says Riddle.

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The same women’s guild that founded Mary Free Bed governs it to this day. It has a profound impact on the hospital’s culture, says Riddle: “These women, many of whom volunteer at the hospital, have created a loving, nurturing atmosphere.”

the FutureThe biggest news at Mary Free Bed

these days is its plan for a $48 million renovation and expansion that will double the facility’s size.

“The main hospital building was built in 1976, and we haven’t done much but maintain it since then,” says

Riddle. “Our model of care is changing, especially in O&P, as we are rethinking the entire process to make sure that the patient has the most enjoyable, inspiring experience, together with the best possible outcome.”

All four fabrication facilities will be under one roof, with state-of-the-art equipment, including computer-aided design and fabrication.

“We’re also developing alternative settings in the hospital to allow patients to ease back into normal life,” says Riddle. “We’re considering having apartments for patients to live in, as well as a cafe, movie theater, and other

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In addition, Mary Free Bed is expanding regionally through collabo-rations with other acute-care providers.

“We have patients coming from a three-state area,” says Riddle. “We want to provide care in other areas around Grand Rapids through joint ventures with other hospitals, such as designing their rehabilitation programs. We have an advanced pain clinic, and we’d like to put that model of pain care in other towns.”

Mary Free Bed’s spirit of collabo-ration is evident in its relationship with the Rehabilitation Institute of Chicago.

“There are warm feelings between the two organizations, and we share best practices with them,” says Riddle. “We learn from each other. This relationship is already bearing fruit here at Mary Free Bed, and it’s just the beginning.” a

Deborah Conn is a contributing writer for O&P Almanac. Reach her at [email protected].

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AOPA HEADLINES

made for AOPA members to visit with their members of Congress and staff.

The importance of the Policy Forum’s impact on O&P issues was underscored by Rep. Thompson, ranking member of the House Education and the Workforce Subcommittee on Health, Employment, Labor, and Pensions, when he took to the House floor on April 17 and made a solid case for enactment of the Medicare O&P Improvements Act (HR 1958 and S. 2125 in the Senate). You can access the video on the AOPA website or www.youtube.com by entering “Rep. Glenn Thompson” in the YouTube search function.

Additionally, Sen. Ron Wyden (D-Oregon) attended an O&P Political Action Committee (PAC) reception in his honor, which was supported by 15 AOPA members. Earlier in the day, another dozen members attended a fundraiser luncheon for Rep. Thompson.

Five legislators at one AOPA Policy Forum sets a new record, but, more important, it emphasizes the significant roles these key legislators play in

AOPA WORKING FOR YOU

The Forefront of Advocacy Nothing beats feet on the street to advance the O&P cause

Attendees listen intently during the General Session. Thomas f. fise, JD, AOPA executive director.

Catriona Macdonald, AOPA lobbyist, presented on vA Procurement Policies, the vA OiG Report, and appropriations and support for O&P education and research.

Representatives Charlie Dent (R-Pennsylvania), Todd Rokita (R-Indiana), Dutch

Ruppersberger (D-Maryland), and Glenn “GT” Thompson (R-Pennsylvania) headlined the Congressional speaker roster for the AOPA Policy Forum, which was held April 17-18, in Washington, DC. Nearly 100 members of the O&P community put their day-to-day activities aside, came to Washington, and became passionate and persuasive advocates on behalf of the entire O&P community. More than 330 appointments were

Sen. Ron Wyden (D-Oregon) Reception.

http://www.youtube.com

the O&P industry and the interests of everyone….All in all, a very infor-mative, eye-opening two days in our nation’s capitol.”

Or for the longtime participants like Walt Racette, CPO, also of Pacific Medical P&O: “Excellent event and for the first time in my career O&P has bills on the floor!!! Keep it rolling.”

Then from Teri Kuffel, Esq., Arise Orthotics & Prosthetics: “Thanks for another great Policy Forum and all you do to make it happen.”

The hot issue—although not on a legislative path—was the physician documentation issue, which seems to bring more bad news every day. CMS contractors have gone too far in trying to make O&P providers the hammer in securing documentation from physicians, especially on lower limb prosthetics and diabetic shoes. Even a top CMS official acknowledges off-the-record the need for a responsible

solution. AOPA Executive Director Tom Fise pulled it all together in a presentation that underscored flaws in the Department of Health and Human Services Office of Inspector General’s (OIG) report that raised documentation issues leading to equally flawed press reports seriously distorting the issue. Raising similar and equally misleading issues was a Department of Veterans Affairs OIG communication pointing to a significant cost differential by VA providers and a higher cost from private O&P providers on lower limb prosthetics. Of course, omitted from the VA cost comparison were necessary overhead items that must be recovered by a private provider. Fise’s presen-tation gave members ammunition to use when discussing patient care issues with their legislators.

John Spiegel, director of the Medicare Program Integrity Group at the CMS Center for Program Integrity, further amplified the role of CMS contractors and implied there may be a “safe harbor” approach related to ramped up physician documen-tation requirements.


AOPA HEADLINES

advancing the O&P policy agenda. Rep. Dent introduced the Insurance Fairness for Amputees Act (HR 4175) and serves on the House Appropriations Committee and the Education and the Workforce Committee. Rep. Rokita serves on the House Budget Committee and the Education and the Workforce Committee’s Subcommittee on Health, Employment, Labor, and Pensions. Rep. Ruppersberger is a co-sponsor of HR 1958 along with Rep. Thompson. Sen. Wyden introduced S. 2125: the Medicare O&P Improvements Act. All play critical roles in legislation affecting O&P.

For those who have never attended a previous Policy Forum, they may have a first impression similar to Jeff Leonard from Pacific Medical P&O, who shared his experience with AOPA:

“First off, unbeknownst to me prior to attending, there are many folks within AOPA who work very hard to protect

from left to right, AOPA President Thomas v. Dibello, CO, fAAOP; Marshal Cohen, chairman of the Executive board, Amputee Coalition; Rep. Charles Dent (R-15th Pennsylvania); and kendra Calhoun, president and CEO, Amputee Coalition. Rep. Dent is presented with an award and is a sponsor of the insurance fairness for Amputees Act (HR 4175).

Sen. Ron Wyden, right, receives an award presented by AOPA Executive Director Thomas f. fise, JD. Sen. Wyden sponsored the recently introduced Medicare O&P improvements Act of 2012 (S.2125).

AOPA State Representative Meeting.

AOPA vice-President Anita Liberman-Lampear, MA, and Les vankuren, CO, meet their Congressman, Rep. Gary Peters (D-9th Michigan).


AOPA HEADLINESAOPA HEADLINES

Members were given a working knowledge of how to get the best results from a legislative visit by Kevin Brennan of Foley Hoag, AOPA’s lobbying firm, while Stephanie Kennan of McGuire Woods, another AOPA lobbyist, focused on the 2.3 percent medical excise tax and the major exemption carved out as a result of AOPA’s targeted lobbying in the initial draft regulations issued by the Department of Treasury. Kennan also reviewed the AOPA research project her firm completed, which analyzed state-by-state benchmark plans meeting the criteria HHS outlined as the basis for defining essential benefits.

The research project examined the four benchmark plans in each state that could meet HHS recommendations and was commissioned by AOPA to provide its members with a heads up on which plans include O&P services and which don’t. Those excluding O&P need to be identified, so AOPA members can convince state officials to make sure a plan including O&P is selected. AOPA Director of Regulatory Affairs Catherine Graf updated members on Food and Drug Administration’s O&P investigations and compliance.

Peter Thomas, counsel to the National Association for the Advancement of Orthotics and

Prosthetics, familiarized members with provisions of the Injured and Amputee Veterans Bill of Rights (HR 805) and how it ensures veterans are informed about their treatment options, including being able to select a private practitioner. He also made a case for how important it is to continue efforts to separate O&P from DME, commented on the essential benefits issue, and provided an update on the off-the-shelf (OTS) orthotics compet-itive bidding issues, noting for now that OTS orthotics are not included.

On April 18, the briefing wrapped up with a recap of the 10 issues covered in the important “2012 Talking Points” document designed to guide the conversation on the key issues deemed most important to O&P. Not every issue could be covered in every meeting, but having a menu board can make all the difference in leaving behind the best information of interest to the member of Congress or his or her staff. In addition, a “leave behind” packet was provided to each AOPA member to help reinforce the visits.

In 2013, we plan to have yet another successful AOPA Policy Forum, so keep it on your radar for events to attend. While it’s too early to set meeting dates, please block the time as soon as firm dates are announced. A new Congress and perhaps even a new administration will warrant the investment of time and energy that provides the O&P community this once a year opportunity to effectively educate the decision makers and policy influencers. a

“Excellent event and for the first time in my

career O&P has bills on the floor!!!

Keep it rolling.”— WALt RACEttE, CPO

AOPA WORKING FOR YOU

Special Thanks to our 2012 Sponsors


AOPA HEADLINES

The road to getting your claims paid begins when the patient first enters your facility. Taking the time to gather vital information at patient intake may mean the difference between payment and denial of a claim.

Join AOPA’s staff experts on Wednesday, July 11, at 1 p.m. EDT for a one-hour audio conference: “Perfecting the Intake Process.” The following questions will be discussed:• What questions should be included on your intake form?• Who in your office should be involved in the

intake process?• How can you educate patients to properly complete the

intake process?• How should you review the intake form with the patient

or caregiver?• How can you get the information you need while

protecting patient privacy?

• What should you do with intake information once it is received?The cost of participating is $99 for AOPA members ($199

for nonmembers), and any number of employees may listen on a given line. Participants can earn 1.5 continuing education credits by returning the provided quiz within 30 days and scoring at least 80 percent. Contact Devon Bernard at [email protected] or 571/431-0854 with content questions.

Register online at https://aopa.wufoo.com/forms/2012-telephone-audio-conferences/. Contact Steve Custer at [email protected] or 571/431-0876 with registration questions.

Perfect Your intake Process— Join the Audio Conference July 11

Master Medicare in Seattle: Essential Coding & Billing Techniques Seminar

Join your colleagues August 6-7 at the Hyatt at Olive 8 in Seattle for AOPA’s

“Mastering Medicare: Essential Coding & Billing Techniques” seminar. AOPA experts will provide the most up-to-date information to help O&P practitioners and office billing staff learn how to code complex devices, including repairs and

adjustments, through interactive discussions and much more. Meant for practitioners and office staff, this advanced two-day event will feature break-out sessions for these two groups to ensure concentration on material appropriate to each.

Basic material that was covered in AOPA’s previous Coding & Billing seminars has been converted into nine one-hour webcasts. Register for the webcasts on AOPA’s homepage.

Register online for the “Essential Coding & Billing Techniques” seminar in Seattle at https://aopa.wufoo.com/forms/2012-mastering-medicare-seattle or contact Devon Bernard at [email protected] or 571/431-0854 with questions.

2012 AOPA Coding Clinic

You and your staff are invited to Baltimore, Maryland, BWI Airport Marriott to participate in a workshop on July 24 designed specifically for AOPA’s supplier members. Representatives from the

Centers for Medicare and Medicaid Services (CMS), AOPA leadership, and staff will discuss current coding issues and the ins and outs of coding applications, as well as hints on improving your chances of success on applications.• How does coding affect product sales?• When in the product lifecycle should you consider coding?• Does the name of a device affect payment?• Who makes the final decision on what devices receive codes?• Can you get a brand name code?• Do Medicare codes affect private payors?• What do I do if my code application is rejected?• If a new code is issued, how does that interact with the

Medicare allowable for that device?Don’t miss this opportunity to advance your company’s

goals—get the answers you need to these questions and more!Register online for the 2012 AOPA Coding Clinic in

Baltimore at https://aopa.wufoo.com/forms/2012-aopa-coding-clinic-baltimore/ or contact Steve Custer at [email protected] with questions or information.

mailto:[email protected]

https://aopa.wufoo.com/forms/2012-telephone-audio-conferences/





AOPA HEADLINES

register Today! Don’t Miss the AOPA National Assembly Early Bird Deadline

AOPA HEADLINES

Learn the ins and Outs of ABNs— Join the Audio Conference August 15

One of the most important and often misused Medicare forms is the Advanced Beneficiary Notices (ABN) form. Join AOPA August 15 at 1 p.m. EDT for an AOPAversity Mastering Medicare audio conference that will focus on and cover the basics of when to use (and not use) an ABN form.

Learn strategies and techniques from an AOPA expert who will address the following topics:• which modifiers to use with the ABN form• additional uses for the ABN form• how to use the ABN to protect your bottom line• tips on how to properly fill out the ABN form.

The cost of participating is $99 for AOPA members ($199 for nonmembers), and any number of employees may listen on a given line. Participants can earn 1.5 continuing education credits by returning the provided quiz within 30 days and scoring at least 80 percent. Contact Devon Bernard at [email protected] or 571/431-0854 with content questions.

Register online at https://aopa.wufoo.com/forms/2012-telephone-audio-conferences/. Contact Steve Custer at [email protected] or 571/431-0876 with registration questions.

Discover Employment Opportunities at AOPA’s Online Career Center

As an O&P professional, you can make a difference every day. Job opportunities abound throughout the country, and the need for O&P professionals is increasing rapidly. Currently, 100 percent of O&P program graduates find employment, and most choose to make it a lifelong profession.

If you’re seeking employment, access the most-recent jobs available. If you’re recruiting, reach the most-qualified candi-dates by posting your job on AOPA’s Online Career Center.

Visit http://jobs.AOPAnet.org, or email Steven Rybicki at [email protected] with questions.

July 20 marks the Early Bird Deadline to receive discounted rates for the AOPA 2012 National Assembly and Northeast Chapter Combined Meeting in historic downtown Boston. Experience the country’s largest, oldest, and most essential meeting for orthotic, prosthetic, and pedorthic profes-sionals. Online registration is open at www.AOPAnet.org.

July 20 also is the cutoff for hotel reservations at the Sheraton Boston for the block of rooms reserved by AOPA. This block of rooms is being held exclusively for Assembly attendees; those booking rooms are required to register for the Assembly by July 20 or they will not be eligible for the group rate and may be subject to cancellation.

The AOPA National Assembly features extensive scientific programs on topics such as scoliosis, micropro-cessor knees, balance, and wound care. Also featured will be unprec-edented business education from experts in the O&P industry covering health-care reform, documentation, business management, accountable care organizations, the Food and Drug Administration, reimbursement challenges, and more.

Dedicated education tracks are offered for pedorthists, post-mastectomy fitters, and technicians.

Register online at https://www.expotracshows.com/aopa/2012/. Look for program updates and registration information at www.AOPAnet.org. Contact AOPA headquarters at 571/431-0876 with questions.

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AOPA HEADLINES

Special Thanks to Our O&P PAC Contributors

The O&P PAC would like to acknowledge and thank the following AOPA members for their recent contributions to and support of the O&P PAC*:

Michael Allen, CPO, FAAOPMaynard Carkhuff

Ronald CheneyEdward DelatorreMark Devens, CPO

Jon leimkuehler, CPO, FAAOPWilliam leimkuehler, CPO

Clyde Massey, CPOSteve McNamee, CP, BOCO, FAAOP

Nina MillerMarlon Moore, CO

Gordon Stevens, CPOJoan Weintrob, CPO

Ashlie WhiteJeffrey yakovich, CO

James young Jr., CP, FAAOPClaudia Zacharias, MBA, CAE

The purpose of the O&P PAC is to advocate for legislative or political interests at the federal level that have an impact on the orthotic and prosthetic community. The O&P PAC achieves this goal by working closely with members of the House and Senate to educate them about O&P issues and help elect those individuals who support the orthotic and prosthetic community.

In order to participate in the O&P PAC, federal law mandates that you must first sign an authorization form. To obtain an authorization form, contact Devon Bernard at [email protected]. a

*Due to publishing deadlines this list was created on May 24, 2012, and includes only donations received and contributions made between April 10, 2012, and May 24, 2012. Any donations received or contributions made after May 24, 2012, will be published in the next issue of the O&P Almanac.

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AOPA HEADLINES

Attention Students: Submit Your Poster Presentations by July 1

AOPA invites O&P students and residents to present research findings or a case study via a poster presentation at the 2012 AOPA National Assembly in Boston September 6-9.

Poster presentations should be a graphical display in a poster format using photographs, diagrams, flowcharts and graphs, and any sample educational materials.

Two awards will be given: The Otto and Lucille Becker Award will be presented for the best orthotic abstract, and the Edwin and Kathryn

Arbogast Award will be presented for the best prosthetic abstract.

The submission deadline is July 1. Poster presentations will be held on Saturday, September 8, from 12 to 2:30 p.m. Titles and authors will be announced on www.AOPAnet.org and in the final program.

To submit your presentation, please visit https://aopa.wufoo.com/forms/2012-call-for-poster-presentations/. Contact Tina Moran with questions, 571/431-0808 or [email protected].

Compete to fabricate a swim prosthesis, and your device may be selected as a cash prize winner! This contest is sponsored by OPTA, Ottobock, Cascade-USA, and AOPA.The first-place prize is $500; second-place prize is $300; and third-place prize is $150. First-, second-, and third-place winners will be selected in both Professional and

Student categories.

SPOnSOred by OPTA, OTTObOCK, CASCAde-USA, And AOPA

Enter the First-Annual AOPA OPTA

Technical Fabrication Contest

Contest Task: Fabricate a finished below-knee (BK) swim prosthesis.

Entry Classifications: Student or Professional.

Student: A Student is anyone currently enrolled an orthotic and prosthetic technician training program or who has graduated from such a program in the spring/summer of 2012.Professional: All nonstudent entries will be entered in the Professional classification.

Overview: Entrants will be provided a digital positive mold and specification sheet. To make the contest accessible to all, a negative cast mold will be sent to those without access to a carver, and a limited number of SACH feet are available for loan.

Request from Clinicians: Fabricate a swim prosthesis. The technician is given free rein in terms of the final shape and cosmetic finishing.

Entry Procedures: To enter, simply complete the online registration form located at https://aopa.wufoo.com/forms/2012-aopa-opta-technician-fabrication-contest/. There is a $25 entry fee.

Entry Deadline: July 30, 2012.

Questions? Contact Steve Custer at [email protected] or 571/431-0876.

Where to Send Contest Submission: Send your submission to AOPA headquarters no later than Tuesday, August 10. You may also bring your device to the AOPA National Assembly in Boston, but your device must be delivered to onsite registration no later than 1 p.m. on Thursday, September 6, as judging will commence that afternoon. Devices will be displayed during the Assembly, and the winner will be announced at the Opening Session on Friday, September 7. Shipments to AOPA headquarters and inquiries should be directed to:

AOPA OPTA Technical Fabrication ContestSteve Custer

330 John Carlyle Street, Suite 200Alexandria, VA 22314

COnTEST DETailS

NEW CONTEST

https://aopa.wufoo.com/forms/2012-call-for-poster-presentations/

https://aopa.wufoo.com/forms/2012-call-for-poster-presentations/


https://aopa.wufoo.com/forms/2012-aopa-opta-technician-fabrication-contest/





Center for Orthotic & Prosthetic inc.6655 Quince Road, Ste. 124 Memphis, TN 38119901/757-5461Fax: 901/757-0909Category: Patient Care FacilityLee Steele

EMR Stat1111 W. San Marnan Drive Waterloo, IA 50701800/214-6742Category: AffiliateParent Company: Orthotic & Prosthetic

Group of America (OPGA), Waterloo, IA

the officers and directors of the American Orthotic & Prosthetic Association (AOPA) are pleased to present these applicants for membership. each company will become an official member of AOPA if, within 30 days of publication, no objections are made regarding

the company’s ability to meet the qualifications and requirements of membership.

At the end of each new facility listing is the name of the certified or state-licensed practitioner who qualifies that patient-care facility for membership according to AOPA’s bylaws. Affiliate members do not require a certified or state-licensed practitioner to be eligible for membership.

At the end of each new supplier member listing is the supplier level associated with that company. Supplier levels are based on annual gross sales volume:

Level 1: equal to or less than $1 million Level 3: $2 million to $4,999,999Level 2: $1 million to $1,999,999 Level 4: more than $5 million.

AOPA APPLICATIONS

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SUPERIOR EDUCATION

ADVANCED PROGRAMS

MYRIAD OF EXHIBITS

EARN CE CREDITS

QUALITY NETWORKING

For information about the show, scan the QR code on the left with a code reader on your smartphone or simply visit www.AOPAnet.org.

� e

Place To Be!

� e

Place To Be!

SUPERIOR EDUCATION

MARK YOUR CALENDAR!

Attend the country’s largest, oldest, and essential meeting for orthotic, prosthetic and pedorthic professionals.

www.AOPAnet.org

Golden Orthotics & Prosthetics111 College Park Plaza Johnstown, PA 15904814/254-4369Fax: 814/254-4372Category: Patient Care FacilityAmanda Martin

infinite biomedical Technologies1101 E. 33rd Street, Ste. A306 Baltimore, MD 21218443/451-7175Fax: 443/451-7179Category: Institution/ResearchDan Schlattman, COO, M.SE

SPS386 Internationale Drive, Ste. ABolingbrook, IL 60440630/786-6418Category: AffiliateParent Company: SPS, Alpharetta, GA

vGM Education1111 W. San Marnan Drive Waterloo, IA 50701800/214-6742Category: AffiliateParent Company: Orthotic & Prosthetic

Group of America (OPGA), Waterloo, IA

WbC industries inc.625 Central Ave. Westfield, NJ 07090908/789-1234Fax: 908/232-5219Category: Supplier Level 1Scott Viglianti

2012


51 Orthoses and Components 51 Orthotics—All 51 Ankle/Foot Orthoses-AFO 52 Hip Orthoses 52 Knee Orthoses 54 Orthoses: Lower Limb 54 Pediatric Orthoses 54 Soft Goods/Orthotic 54 Spinal Orthoses 54 Upper Extremity: O&P

55 Prostheses and Components 55 Prosthetics—All 56 Prosthetic Components 56 Soft Goods/Prosthetics 58 Feet 58 Foot Care: Custom Footwear 60 Foot Care: Therapeutic Shoes 60 Lower-Limb Prosthetics 61 Prosthetic Liners

61 Miscellaneous 61 CAD/CAM Systems 62 Central Fabrication 62 Specialty O&P Distributors

63 Reference Materials and Business Services

64 Comprehensive Index

Contents

The annual

one-stop resourcefor o&P ProducTs

and services

BUYERS’ GUIDE


2012Orthoses andComponentsortHotIcs—ALL

Becker Orthopedic635 executive drive Troy, Mi 48083800/521-2192BeckerOrthopedic.comBecker Orthopedic was founded in 1933 by Otto K. Becker to provide high quality, innovative, orthotic components and central fabrication services. His vision continues today with new product offerings like the Stride Stance Control Family and SpineCor®. When it comes to orthotics, Becker has the options you are looking for.• Largestorthoticcomponentselectionavailable• Customcentralfabricationservices• Dedicatedtechnicalsupport• Knowledgeablecustomerservicestaff• Educationalin-services• OnlinesupportviaWebEx For more information, or assistance with component selection, fabrication, or problem solving, contact Becker Orthopedicat800/521-2192orvisitBeckerOrthopedic.com.

Bulldog Tools Inc.4140 us route 40 elewisburg, oh 45338 937/962-0205Bulldog Tools Inc. is a family owned and operated Genu-ine U.S.A. Company providing Prosthetic and Orthotics supplies.WearelocatedinLewisburg,OhionearDayton.We specialize in designing, engineering, and manufacturing our own line of certified high quality products and materi-als at a revolutionary low cost while continuously providing new and innovative products. At Bulldog, it’s our unsur-passed commitment to make our valued customers and their customers happy by simply treating them with straight forward respect, fairness, and honest business practices while providing the best products at the best prices we ourselves would want and expect.

OPPO Medical Inc.1030 industry driveTukwila, Wa 98188800/979-1932www.oppomedical.comYou can expect to find the most extensive line of functional braces,3-Dknitsupports,andawardwinningdesignsfromOPPO Medical Inc. Since 1997, Oppo has designed and developed product lines with:• Long-standingcommitmenttouncompromisingquality

in workmanship and customer service• Keenunderstandingoftherehabilitationmarketandthe

needs of our customers• Passionforinnovation,sharedbyateamofhighly-moti-

vated & talented employees. Formoreinformation,callusat800/979-1932orvisitwww.oppomedical.com.

Soletech Inc. 425 Washington st., suite 4claremont, nh 03743Toll free Tel: 877/625-9494outside usa: 603/542-8905fax: 603/542-8909contact: Kevin Mcnamara [email protected] Establishedin1946,Soletechhasafulllineoffabrica-tion materials for the O&P industry including the largest selectionofEVAsheets,multi-durometerlaminatedsheetsand blockers, Poron, Plastazote, Neoprene sheets, diabetic insoles, rubber and crepe outsoles and many other foam materials. Soletech introduced its registered brand of Cloud EVAtotheO&Pindustryintheearly1980’sandisrecog-nized as the industry leader for fabrication materials for customfootorthoticsandAFO’saswellasforbuild-upsandshoe modifications. Soletech is an authorized distributor of medical grade Poron from Rogers Corp.

AnkLe Foot ortHotIc–AFo

Allard USA Inc.rockaway, nJ888/[email protected]


Euro International Inc.5906 Breckenridge Pkwy., suite G Tampa, fl 33610-4236800/378-2480www.eurointl.comEuroInternationalispleasedtoannouncethelaunchofthePeroSupport.pro AFO, a dynamic peroneal brace which features all the benefits of its predecessor, the PeroSupport.tec but offers extra calf stabilization, is more rotationally stable and absolutely convinces with its newly improved anatomical design. The foot part can be ground to the marked area, which is very helpful for customization of the orthosis to the patient’s foot size or shoe size. The Pero-Support.pro assists for indications like: peroneal paresis, weakness of dorsiflexion of foot, inflammation of the ankle joint,post-operativetreatmentafterachillestendonrupture,malposition of the ankle joint caused by weakness of the dorsiflexion of the foot etc. The PeroSupport.pro is available inthesizesStoXL,forshoesizesfrom36-48andcomesinthe color black for the right and left the foot. Formoreinformation,callusat800/378-2480orvisitwww.eurointl.com.

Orthomerica Products Inc.—Spectrum Slim™ Gauntlet6333 n. orange Blossom Trail orlando, fl 32810-4223877/737-8444www.orthomerica.com

Orthomerica® Products Inc. introduces the Spectrum Slim™ a valuable addition to our Spec-trum™ AFO product line. This slimmer and sleeker, supremely crafted gauntlet offers maximum comfort and provides your patients with a greater range of shoe options plus, it is heat adjustable. The Spectrum Slim™

is ideal for patients that find standard gauntlets a challenge to get into a shoe and its low profile design makes donning and doffing much easier for the patient. It is available in black or tan leather or black or white synthetic material. For more information on this or other products, call 877/737-8444orvisitwww.orthomerica.com.

SureStep17530 dugdale drive south Bend, in 46635877/462-0711www.surestep.net

SureStep is the most effective means of providing stability to children who pronate when standing and walking. This patented, dynamic system allows children to gain stability, while still allowing normal movement and function. Children with low muscle tone who have trouble with stability due to pronation can

now walk, run and jump without the delays and instabilities that often result. SureStep is not a different brace, but rather a completely unique system that manages the foot andanklewithoutover-managing. Formoreinformationcall877/462-0711orvisit www.surestep.net.

HIp ortHoses


knee ortHoses



http://surestep.net/media/images/low_muscle_tone.jpg

http://surestep.net/media/images/low_muscle_tone.jpg

http://surestep.net/media/images/pronation.jpg

Liner & SleeveExtreme Advantage--

Indicated for Transfemoral OR ACTIVE Transtibial amputees; Reduce on-hand inventory cost and space requirements through application on either TT or TF amputees.

Extreme Cushion

Extreme Contact-- 80% Less Vertical Stretch

As compared to other Alps gel liners, resulting in demonstratively increased contact while stabilizing movement of redundant tissue.

Extreme Suspension-- New GripGEL™ is more tactile than EZGel to gently but fi rmly support the residual limb and sensitive tissues.

Alps New Extreme Cushion Liner has limited vertical

stretch to reduce movement of redundant tissue. Use appropriate for TT or TF

applications.



NOW IN STOCK:


Alps New Extreme Sleeve seals against the skin without

restricting circulation or causing shear forces. ALPS GripGel helps prevent the

sleeve from rolling down the patient’s limb.

Providing more of what you

want and need!

Extreme Versatility-- Cushion liner available in 3 mm or 6mm Uniform profi le to fi t circumferences ranging from 16-53 cm. Sleeve available in 3mm or 6mm in sizes 20 - 70 cm.

Z Flex LinerE


Hardly just a pretty face,the EZ Flex Liner

delivers unequaled function without sacrificing anything.

Practical Magic











cm to 44 cm.





NOW IN STOCK:



ortHoses: LoWer LIMB


The Xeleton: Custom Function in an Off-the-Shelf Knee Brace from OttobockTwo carlson Pkwy. n, suite 110Minneapolis, Mn800/328-4058www.ottobockknees.com

TheXeletonoff-the-shelfkneebrace from Ottobock brings customizable function for sports injuries,pre-orpost-surgicalstabilization, or therapy for chronic knee joint instabilities. TheXeleton’santi-migrationfeature keeps everything secure while providing both prophylactic and optimal rehabilitation support.

A custom strap system takes this durable product from off-the-shelftoacustomfitthatmatchesthepatient’sindications.DifferentconfigurationsoftheXeletonaddresstheanteriorcruciateligament(ACL),theposteriorcruciateligament(PCL)orcombinedinstabilities(CI).And,thankstoitsanatomicalshapeanduser-friendlydesign,Xeletonalsooffers extraordinary wearer comfort. Call800/328-4058orvisitwww.ottobockus.com.

pedIAtrIc ortHoses


soFt Goods/ortHotIc

Knit-Rite Orthotic Textiles120 osage ave.Kansas city, Ks 66105800/821-3094www.knitrite.com

Knit-Rite’sOrthoticTextileInterfaces offer patients comfort and protection in their everyday lives. We are proud to offer products including patented SmartKnit Seamless AFO and KAFO socks, Torso Interfaces®, cranial interfaces, fracture inter-faces,SmartKnit® and Therasock®DiabeticSocks,anda

full line of Therafirm® Gradient Compression Hosiery and Core-SpunbyTherafirm™SupportSocks. Formoreinformation,contactKnit-Riteat800/821-3094 or email [email protected].

spInAL ortHoses


Atlanta International—Scoliosis and Spinal Bracing1979 Parker court, suite d&estone Mountain, Ga 30087800/543-7660www.aibracing.comOurlineofLSOmodulesmeetseveryneedinL1-L5levelpathologies.Eachpatient-friendlyuniquedesignworksto optimize support with greater comfort and, therefore, greaterpatientcompliance.OurTLSOmodulesoffersaflexible array of support options for a full range of thoracic and lower back indications A choice of plastic shell and liner densities assures a more precise balance of rigid-ity and support with greater mobility and comfort for the patient. Give us a call today!

upper eXtreMItY: o&p

Texas Assistive Devices LLCBrazoria, TX800/[email protected]


Prostheses and ComponentsprostHetIcs—ALL

ARTech Laboratory Inc.309 West ave. fMidlotian, TX888/775-5501www.artechlab-prosthetics.com

The loss of a limb causes deep emotional trauma. Apart from the obvious difficulties with mobility andself-care,thedisturbanceinbody image requires significant emotional readjustment. Our objective is to eliminate the stigma associated with the disfigurement. As opposed to the robotic or mannequin look of a

traditional prosthesis, our restorations have a natural appearance since they are sculpted and painted to match the opposite limb. Without close examination, ARTech’s prostheses are virtually undetectable. It is our privilege to workinanindustrythatgivesself-sufficiency,mobility,andself confidence back to those with amputations and birth defects. For more information, call 800/775.5501 or visit www.artechlab-prosthetics.com.

Bulldog Tools Inc. 4140 us route 40 elewisburg, oh 45338 937/962-0205Bulldog Tools Inc. is a family owned and operated Genu-ine U.S.A. Company providing Prosthetic and Orthotics supplies.WearelocatedinLewisburg,OhionearDayton.We specialize in designing, engineering, and manufacturing our own line of certified high quality products and materi-als at a revolutionary low cost while continuously providing new and innovative products. At Bulldog, it’s our unsur-passed commitment to make our valued customers and their customers happy by simply treating them with straight forward respect, fairness, and honest business practices while providing the best products at the best prices we ourselves would want and expect.

KISS Technologies—Reformulated KISS® Adhesive: Amazing Adhesion8517 loch raven Blvd.Baltimore, Md 21286410/663-Kisswww.kiss-suspension.com

The reformulated KISS adhesive features increased flexibility and less time needed for bonding. The adhesive bonds porous and nonporous surfaces, and bonds flexible as well as rigid materials. It is packaged in two separate bottles for increased shelf life. For more information, call

410/663-KISS(5477)orvisitwww.kiss-suspension.com.

The Troppman Grip from Troppman Prosthetics Ltd.5341 75 st.edmonton aB T6e 0W4www.troppmangrip.com

• Universalapplication-slipon/offany club without adjustments or locks.

• Mimicsnaturalwrist/action.• Strong,flexiblehoseadapts

to shorter or longer residual limbs/sockets.

• Customcolorsavailable. Bottom Hand Grip, Junior Troppman Grip, Trans Humeral Troppman Grip and the Regular Troppman Grip all available in

theU.S.throughSPSandCascade,inEuropethroughRSLSteeper, and directly through Troppman Prosthetics. For more information on the Troppman Grip, call us at 866/[email protected].

WillowWood Co. 15441 scioto darby rd. Mount sterling, oh 43143-9036800/848-4930www.willowwoodco.comWillowWood is dedicated to partnering with clinicians by providing quality prosthetic products like the Alpha® Family ofLiners,LimbLogic®VS,OMEGA® and the Fusion™ Foot. We work closely with clinicians to create strong relationships and solutions for their patients. WillowWood has the leading technologyinCADsoftwareandactivevacuumsuspensionas well as one of the most robust product lines of pros-thetic liners within the industry. We are here to help you craft prostheses that deliver mobility, comfort, and range of motion so your patients see satisfying, active futures. Callusat800/848-4930orviewourcompleteproductline at www.willowwoodco.com.

http://www.kiss-suspension.com


prostHetIc coMponents

American Prosthetic Components LLC900 ontario rd.Green Bay, Wi 54311800/772-7508www.apcomponents.com

Quality, Price & Availabil-ity—APC was the first to offer a 5 Year No Questions Asked Warranty. Others may follow but APC is leading the way in quality, service and innovation.OurHigh-

Tech manufacturing facility in Green Bay, Wisconsin allows us to keep the price competitive. We focus on saving facilities money without sacrificing quality. APC is an American company with American values. America prides itself on quality and service and that is what we provide. QUALITY,SERVICEandAVAILABILITY!Customizeyourpylons with your company logo at no additional charge. Formoreinformation,call800/772-7508orvisitwww.apcomponents.com.

soFt Goods/prostHetIcs

ALPS—ALPS Prosthetic Socks2895 42nd ave. nsaint Petersburg, fl 33714800/574/5426www.easyliner.com

FlatbedmanufacturingallowsALPStoprecisely control the shape and thickness, without adjusting yarn volume or tension—whichcancreatenon-uniformwearandconstriction in unwanted areas. Because ALPSdoesnotremovefiberstocreateitsoft feel, the sock does not loose volume and will not mat down. Performance based moisture management system of Coolmax moves perspiration away from the body and

through the fabric, where it can evaporate quickly, allows wearer to feel cooler and more comfortable. The plastic reinforced hole prevents fraying of the seam around the distal hole. Formoreinformation,call800/574-5426 or visit www.easyliner.com.

Comfort Products Inc.—Complete Line of Prosthetic Socks931 river rd.croydon, Pa 19021800/822-7500www.comfortoandp.com

The Comfort Products tradition lives on in the latest advancements in fiber technology with the finest knitting equipment available. Throughout the years we have become theInnovationLeaderin

Knitted Orthotic and Prosthetic Products. Our innovations include:• FirsttoincorporateX-Static® silver yarn into products for

Orthotics & Prosthetics• FirsttoofferaSeamlessDiabeticSock• FirsttomarryX-Static® silver yarn with CoolMax® fabric• DevelopedandintroducedSpectraCarb™,aunique

lamination stockinette that combines Spectra Fibers and Carbon.

We are committed to providing the best knitted products with the latest innovations and highest quality for wearers of orthotic and prosthetic devices. We believe that this commitment is unparalleled in the world of orthotic and prosthetic knitted goods today. With our full line of Pros-thetic Socks we have something for everyone! For more information, contact Comfort Products at 800/822-7500orwww.comfortoandp.com.

Knit-Rite Prosthetic Textiles120 osage ave.Kansas city, Ks 66105800/821-3094www.knitrite.com

Improve your patient’s lives with Knit-RiteProstheticTextiles.Through dedicated focus on textile research and working with practitioners,Knit-Ritecontinuesto advance textile solutions that promote mobility, protection, and comfort. We offer a complete selectionofhigh-qualityandeffective products, including a

variety of prosthetic socks, prosthetic sheaths, prosthetic shrinkers, lower extremity suspension products, and fitting sockswithestablishedbrandsofSoft-Sock®,X-Wool®, A-Plus™,OriginalCompressogrip®, Power Belt, and Liner-Liner®.

Formoreinformation,contactKnit-Riteat800/821-3094or email [email protected].

PEL Supply Co. Offers ALPS Coolmax® Prosthetic Socks4666 Manufacturing ave. cleveland, oh 44135-2638800/321-1264www.pelsuppy.com

Theperformance-basedmoisturemanagementsystemofALPSCoolmax® Prosthetic Socks wicks perspiration away from the body and through the fabric, where it can evaporate quickly, allowing the wearer a more comfortable experience. Proprietary manufacturing methods allowALPStoproduceasockwhichminimizesstretch (up to 1/3 the stretch of competitor’s

socks)toensuresockthicknessismaintainedforthelifeofthe sock. It allows them to control shape and thickness, without adjusting yarn, volume, or tension, which can create non-uniformwearandconstrictioninunwantedareas.• MatFree• Availablewithorwithoutdistalhole(sockswithoutdistal

holeareavailablewithorwithoutreinforcement)• Plasticholereinforcementtopreventfrayingofseam

around hole• Seameddistalend. ContactPELSupplyat800/321-1264,fax800/222-6176, email at [email protected], or order online at www.pelsuppy.com.

TuffToe® available from PEL Supply Co.4666 Manufacturing ave. cleveland, oh 44135-2638800/321-1264www.pelsuppy.com

When ordinary socks just won’t do…get TuffToe® prosthetic socks from Rx Textiles. Featuring a gel-reinforceddistalhole,TuffToe socks fill the space between the liner and the socket when

volume changes occur throughout the day. They are thinner at the distal end so that more socks can be added without the limb being pushed out of the socket. Features include: • Reinforceddistalend• Volumecontrol• Supersoftelasticmaterial• AKandBKsizes • AskPELforaFREEsample. ContactPELSupplyat800/321-1264,fax800/222-6176, email at [email protected], or order online at www.pelsuppy.com.



Feet

Ferrier Coupler Inc.north Branch, Mi800/[email protected]

The PROPRIO FOOT® by Össur®— Stable, smooth and comfortable. And now available for a wider patient range.27051 Towne centre foothill ranch, ca 92610800/233-6263www.ossur.com/propriofoot

Now available for user weights up to275lbsandsizes22-30cm,the newly redesigned PROPRIO FOOT features powered dorsiflex-ion during swing phase, and 28° of smooth ankle flexion, for consistent toe clearance and ground compliance. Now amputees can confidently and naturally walk on grass, ramps

andotherunevengroundwithouttheever-presentfearoftripping and falling. To learn more about the redesigned PROPRIO FOOT byÖssur,call800/233-6263orvisitwww.ossur.com/propriofoot today.

Ottobock—The Triton Family of Feet from OttobockTwo carlson Pkwy. n, suite 110Minneapolis, Mn800/328-4058www.ottobockknees.com

Now you can offer your patients more functional options from Ottobock, the global leader in foot sales. The Triton family of feet can handle the needs ofallyourhigh-activitypatients.Eachfoot

features a split carbon toe, multiaxial terrain conformance, heel stiffness adjustment, and a weight limit up to 330 lbs. Bestofall,therenownedC-Leg® knee goes great with any of Ottobock’s newest feet: the lightweight Triton carbon fiber foot, the Triton Harmony® (with integrated vacuum technol-ogy),andtheTritonVS(featuringverticalshockandtorsion). Call800/328-4058orvisitwww.ottobockus.com.

PEL Supply Offers Wave Comfort Foot System4666 Manufacturing ave. cleveland, oh 44135-2638800/321-1264www.pelsuppy.com

The Fillauer Wave Comfort Foot System utilizes unique tri-springdesignelementsthat allow for seamless transi-tion and stable progression fromheel-striketotoe-off.The reaction of the coupled springs promotes a supple

feel while maintaining a dynamic response, and the novel wave spring and variable durometer heel bumpers enhance stability at heel strike through shock absorption and plantar-flexion.Whencombined,thesmoothactionoftheheel rocker and the stable dynamics of the forefoot insure a

“Wave of Comfort” from heel to toe. Ideal for low to moderate activity level amputees, it is available in sizes 22–30 cm, carryingaweightratingof275lbs(125kg). ContactPELSupplyat800/321-1264,fax800/222-6176, email at [email protected], or order online at www.pelsuppy.com.

Foot cAre: custoM FootWeAr

Soletech Inc. 425 Washington st., suite 4claremont, nh 03743Toll free Tel: 877/625-9494outside usa: 603/542-8905fax: 603/542-8909contact: Kevin Mcnamara [email protected] Establishedin1946,Soletechhasafulllineoffabrica-tion materials for the O&P industry including the largest selectionofEVAsheets,multi-durometerlaminatedsheetsand blockers, Poron, Plastazote, Neoprene sheets, diabetic insoles, rubber and crepe outsoles and many other foam materials. Soletech introduced its registered brand of Cloud EVAtotheO&Pindustryintheearly1980’sandisrecog-nized as the industry leader for fabrication materials for customfootorthoticsandAFO’saswellasforbuild-upsandshoe modifications. Soletech is an authorized distributor of medical grade Poron from Rogers Corp.


Foot cAre: tHerApeutIc sHoes

Apis Footwear Company2239 Tyler ave., suite Bel Monte, ca 91733888/937-2747www.apisfootwear.com

Apis is devoted to offering our customers high quality, genuine leatherDiabetic/Therapeuticfootwearofftheshelforcustom-made, comfortable accommodative orthotics custom made for your patient using top quality materials, value added services include guaranteed fit for custom-madeshoes,shoe

modification services, free foam boxes, free samples and no-hasslereturnpolicy,largeinventory,andquickturn-around. Together with your support and our continuous efforts, Apis Footwear Company is striving to become a one-stopshopforallyourtherapeuticfootwearneeds. Pleasecallourfriendlycustomerserviceat888/937-2747 or visit www.bignwideshoes.com.

LoWer-LIMB prostHetIcs


FLO-TECH®

O&P Systems Inc.7325 halseyville rd. Trumansburg, nY 14886-0462800/356-8324 The APOPPS®(AdjustablePost-OperativePreparatoryProstheticSystem)featuringtheFLO-TECH-TOR™with:one-piececonstruction,unparalleledvolumereduction,compression concentrated medially and laterally, easy access to bandages for attentive wound care, and early weight bearing when using an Universal Frame Outer Socket(UFOS™).Thethree-partadjustablesocketsystemprovidespost-operative,earlyandpreparatoryprostheticcare.TheFLO-TECH-TOR™providescontrolledandmoni-toredweightbearing.Earlyinterventionwithaprotectivedevice minimizes injury caused by: an accidental bump, slipping or falling, transfers or simply trying to shift one’s weight in bed; thus decreasing the incidents of post ampu-tationrevision(s).

Össur Americas Inc.—The New SYMBIONIC LEG®. GO CONFIDENTLY with the first & only complete bionic leg.27051 Towne centre foothill ranch, ca 92610800/233-6263www.ossur.com

SYMBIONICLEGisthefirstcompletebionic leg that combines a microproces-sor knee and a powered, microprocessor foot with proactive ankle flexion. Available in 9 sizes (22-30cm),andwithaweightlimitof275lbs,SYMBIONICLEGisappropriatefor a broad spectrum of above knee amputees. With consistent dorsiflexion during swing, and a 28° flexion range, it

provides unmatched toe clearance and ground compliance for enhanced safety enabling transfemoral amputees to stably and confidently traverse terrain they might otherwise avoid such as grass, ramps and uneven ground. TolearnmoreaboutthenewSYMBIONICLEG® by Össur, call800/233-6263orvisitwww.ossur.com today.

A Family of Solutions from Ottobock—Advanced Prosthetic Knee TechnologyTwo carlson Pkwy. n, suite 110Minneapolis, Mn800/328-4058www.ottobockknees.com

Ottobock introduced the microprocessor-controlledkneeto the world in 1997 and today’sthird-generationC-Leg®, the most clinically evaluated prosthetic knee in history, remains the Standard of Care forabove-kneeamputees.The

introduction of the intuitive Genium® Bionic Prosthetic System opens up a whole new realm of mobility for ampu-tees. Backwards, forwards, up, down—it’s the closest technology has come to a natural, physiological gait. TogetherwiththeCompact(forlowermobilitypatients),Ottobock’s family of microprocessor knees brings its clinically proven advantages to all your patients. Visitwww.ottobockknees.com to learn more about the benefits of Ottobock’s advanced microprocessor knees.


Ottobock Aqualine: New Waterproof Prostheses from OttobockTwo carlson Pkwy. n, suite 110Minneapolis, Mn800/328-4058www.ottobockus.com

With Aqualine, patients can move with confidence in water or wet areas. This line of components from Ottobock is designed specifically for use as a water-proof prosthesis. Take them into salt water, chlorinated water or bath water: the specially adapted components increase security and function in the water—plus,

moisture won’t wear them down. This modular system is idealforpeoplewitheitherbelow-kneeorabove-kneeamputations and all components can accommodate weights up to 330 lbs. The Aqualine system includes specially modified adapters, pylons and a tube clamp along with the waterproof knee and foot. Call800/328-4058orvisitwww.ottobockus.com.

prostHetIc LIners

WillowWood CompanyThe Alpha Family of Liners15441 scioto darby rd. Mount sterling, oh 43143-9036800/848-4930www.willowwoodco.com

Alpha®Linersaredesignedtoprotect residual limbs from abrasion and breakdown. Within theAlphaLinerFamilynumerousoptions exist for optimum fit and comfort for patients. Alpha ClassicandHybridLinerscontainmineraloilandvitaminEmakingthemskin-friendlyandextremelycomfortabletowear.EachAlpha

DESIGN®Liner,witheitherclassicorhybridgel,hasacustom-tailoredgelpatterntomeetpatientneeds.AlphaSiliconeLinersuseaproprietaryblendofsilicone,vitaminE,and skin conditioners, yielding a pleasing surface that is non-greasy,non-tacky,andcomfortableagainsttheskin. ContactWillowWoodat800/848-4930orvisit www.willowwoodco.com.

MiscellaneouscAd/cAM sYsteMs

Delcam—Delcam Healthcare Solutions275 e. south Temple #305salt lake city, uT 84111887/335/2261www.orthotics-cadcam.comDelcamCustomOrthoticInsolesSolutionsprovidemedi-cal laboratories and practitioners with scanning and digital technology,alongwithCAD(computeraideddesign)andCAM(computeraidedmachining)softwaretoautomatethe process of delivering patients specific custom insoles. The3Ddigitalprocesscancaptureanddisplaytheuniqueshape and structure of your patient’s feet in seconds. Once capture the model is sent along with a patient prescription toyourlaboratory.Herethe3Ddigitalmodelisusedtocreate your patients unique custom insole, which perfectly matches the prescription. The result is a high quality, long lasting insole for your patient at a reduced costs to you by 75% or more.

Increase Earnings and Simplify Billing

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p. (810) 629-6424 - f. (810) 629-6463www.oandpoffice.com

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Your Easiest and BestBilling Solution


centrAL FABrIcAtIon

Becker Orthopedic635 executive dr. Troy, Mi 48083800/521-2192BeckerOrthopedic.comBecker Orthopedic was founded in 1933 by Otto K. Becker to provide high quality, innovative, orthotic components and central fabrication services. His vision continues today with new product offerings like the Stride Stance Control Family and SpineCor®. When it comes to orthotics, Becker has the options you are looking for.• Largestorthoticcomponentselectionavailable• Customcentralfabricationservices• Dedicatedtechnicalsupport• Knowledgeablecustomerservicestaff• Educationalin-services• OnlinesupportviaWebEx For more information, or assistance with component selection, fabrication, or problem solving, contact Becker Orthopedicat800/521-2192orvisitBeckerOrthopedic.com.

Becker Oregon2280 Three lakes rd. se albany, or 97322-9582800/866-7522beckeroregoncatalog.comBeckerOregonisafull-servicecentralfabricationfacilitythat offers:• Stancecontrolorthoses• Traditionalthermoplasticandmetalandleatherorthoses• Prefabricatedorthoses• Rotationalcontrollaminatedorthotics. You can trust Becker Oregon for unsurpassed quality, fit, and timely delivery. We know how to establish clear lines of communication with our customers to ensure we meet or exceed your expectations every time. Providing your patients with a Becker custom orthosis means less time fitting and more productive time for you. Formoreinformation,callBeckerOregonat800/866-7522 or view our catalog online at beckeroregoncatalog.com.

OttobockTwo carlson Pkwy. n, suite 110Minneapolis, Mn800/328-4058www.ottobockus.comWhether your fabrication job is simple or complex, you want specialty facilities with the broadest range of services available, staffed by knowledgeable, caring people. That’s why Ottobock Fabrication Services is a perfect partner for your business: we offer decades of expertise, exceptional customer service, and an unparalleled reputation for quality.

Our unmatched technical expertise combined with superior Customer Service is there to support and optimize your fabrication needs. You can count on the best results even with “temperamental” materials—our experts will give you exactly what you need. Callusat800/795-8846orvisitwww.ottobockus.com.

Solis O&P Inc.720 east eau Gallie Blvd. indian harbour Beach, fl 32937866/724-8830solisoandp.com

Outsourcing works when you choose Solis O&P. Why? Because we get it right the first time! How? We are dedicated to personal service. You can speak to a technician 24/7. We specialize in lower and upper extremities. Solis will exceed your most challenging patient’s needs. With decades of experience your 100% satisfaction

is guaranteed. You will be happy with our value priced products and services. At Solis we create custom lamina-tions that produce smiles. We offer free shipping and next day turnaround is always available.Callusat866/724-8830.

specIALtY o&p dIstrIButors

Euro International Inc.5906 Breckenridge Pkwy., suite G Tampa, fl 33610-4236800/378-2480www.eurointl.comEuroInternational’snewestprogramadditionistheMASTERFLEXCOLOR,apermanentelasticdeepdraw-ing sheeting material with high elasticity and dimensional stability.MASTERFLEXCOLORisavailableindifferentthicknesses and in 15 color variations—which makes this material a novelty on the market because as far as we know, EuroInternationalisthefirstcompanywithsuchabroadand vibrant color palette.• MasterflexTransparentandMasterflexColorapplications• Innershoematerial• Waterproofsplints• Metacarpus/forearmsplints• Arm/footprostheses• Peroneal/ankle/footcaps• Trialshoes• Trialprosthesesforthighamputations. Formoreinformation,callusat800/378-2480orvisitwww.eurointl.com.


2012 AOPA Coding Suite

UPDATED MEDICARE CODES

The Most Popular Orthotic and Prosthetic Illustrated Reference!

COMPREHENSIVE GUIDE

A M E R I C A N O RT H O T I C & P R O S T H E T I C A S S O C I AT I O N ( A O PA )

for Orthotics and Prosthetics

2012ILLUSTRATED GUIDE

AOPAPRODUCTS

AOPAPRODUCTS

The Defi nitive Orthotic and

Prosthetic Coding Resource

O&P MEDICARE CODES and FEE SCHEDULE

A M E R I C A N O RT H O T I C & P R O S T H E T I C A S S O C I AT I O N ( A O PA )

Software Includes

2012CODINGPRO

CodingPro 2012 CD Cover.indd 1

2/29/12 7:41 AM

Texas Assistive Devices LLCBrazoria, TX800/[email protected]

TexasAssistiveDevices(TAD)distributesUEprostheticandorthotic components for individu-als with hand dysfunction or amputation.TAD’sproductsinclude an interchangeable tool systemfeaturingtheN-AblerIIto

which a variety of adapted tools and utensils can be attached.TheN-AblerIIoffers360°radialdeviationand60°flexion on any plane, so that tools and implements can be held at a natural angle allowing the user to independently perform activities which might otherwise be impossible (eating,cooking,grooming,carpentry,fishing,etc.).TAD’sproductsco-ordinatewithbody-poweredormyo-electricprostheses,aswellaswithwrist-hand-othoses(WHO)braces.AllhaveLCodes.

Reference Materials & Business Services OttobockTwo carlson Pkwy. n, suite 110Minneapolis, Mn800/328-4058www.ottobockus.comCooperative Care offers personalized support for difficult or high-techfittings,suchashipdisarticulationorupperlimbamputations. Our Professional and Clinical Services staff works with you to speed up the fitting process and obtain excellent outcomes—while you retain your patient. Call or email to receive a quote that includes detailed estimates forcomponents,fabricationandclinicalservices:763/489-5165 or contact us at [email protected]. Reimbursement assistance from Ottobock is just a phone call away. Talk to our expert staff about the Medicare process, codes, and help with appeals. We’re here to help: call800/328-4058andasktospeakwithareimbursementspecialist.

2012 AOPA Coding Products CodingSuiteNewLcodes?Noproblem!Orderthe2012AOPA Coding Suite today! Get your facility up to speed, fast, on all the O&P HCPCS code changes with an array of 2012 AOPA coding products. Get illustrations of each HCPCS code and the AOPA interpretations with the 2012 Coding-Pro software and 2012 Illustrated Guide. The CodingPro also contains Medicare fee schedules and medical policy information.Ensureeachofyourstaffhasa2012QuickCoder,adurable,easy-to-storedeskreferenceofalltheO&P HCPCS codes and descriptors. Now being offered at a lower price! (Coding Suite includes CodingPro single user, IllustratedGuideandQuickCoder):$350AOPAmembers,$895non-members.• CodingProCD-ROM(single-userversion):$185AOPA

members,$425non-members.• CodingProCD-ROM(networkversion):$435AOPA

members,$695non-members.• IllustratedGuide:$185AOPAmembers,$425non-

members.• QuickCoder:$30AOPAmembers,$80non-members. Order at www.AOPAnet.org or by calling the AOPA book-storeat571/431-0865.

The O&P Almanac’s Buyers’ Guide is paid advertising. Entriesweresubmittedandpaidforbyproductmanufactur-ers and distributors. AOPA and the O&P Almanac do not endorse, support or recommend the use of any specific products included in the Buyers’ Guide. In addition, AOPA and the O&P Almanac neither sanction nor approve manufacturers’ claims about the function or reliability of their products. These listings can also be found on AOPA’s website: www.AOPAnet.org. When you contact manufacturers about these products, be sure to tell them you saw them in the O&P Almanac Buyers’ Guide.


Ability Dynamics LLCTempe, aZ480/[email protected]

ACOR Orthopaedic Inc.cleveland, oh216/662-4500

[email protected]

Acsys Orthopedicvista, ca760/[email protected]

Advanced O&P Solutions LLChickory hills, il708/237-4088 [email protected]

Aetrex Worldwide Inc.Teaneck, nJ201/833-2700 [email protected]

AliMed Inc.dedham, Ma800/225-2610 [email protected]

+Allard USA Inc.rockaway, nJ888/[email protected] ALPSsaint Petersburg, fl800/574-5426 [email protected]

Alternative Prosthetic Services Inc.Bridgeport, cT203/367-1212www.alternativeprosthetics.cominfo@alternativeprosthetics.com

American Central Fabrication shreveport, la318/[email protected]

American Orthopedics Manufacturing CorpBrooklyn, nY866/[email protected]

American Prosthetic Components Inc.Green Bay, Wi800/772-7508 [email protected]

+Amfit Inc.vancouver, Wa800/356-3668 [email protected]

Anatomical Concepts Inc.Poland, oh800/837-3888 [email protected]

Apis Footwear Co.el Monte, ca626/448-8905 [email protected]

Argo Medical Technologies Ltd.949/[email protected]

Arizona AFOMesa, aZ480/222-1580 [email protected]

ARTech Laboratory Inc.Midlothian, TX972/775-2000 [email protected]

Aspen Medical Productsirvine, ca800/295-2776 [email protected]

Atlantic Rim Brace Manufacturing Corp.nashua, nh800/233-0356 [email protected]

ATLAS Internationalrancho cordova, ca916/[email protected]

Bader Prosthetics & Orthotics/Kinetic Research Inc.Tampa, fl813/962-6100 [email protected]

Becker Oregon Inc.albany, or541/967-1821 [email protected]

companies in bold are aoPa members.companies with + are supplier Plus Partners.

COMPREHENSIVE

INDEX

http://www.acsysortho.com


http://www.atlasortho.com


FranchiseOppOrtunities

available

Proven Model Offering:• Walk-In Retail• Wholesale Sales• 3rd Party & Gov’t Insurance Billing• Worker’s Comp Contracting

Your Complete Resource For:• Orthopedic Bracing• Sports Medicine Products• Home Health/Durable Medical• Custom/OTC Orthotics• Athletic Training Supplies

contact Mike Findley at 402.493.4747www.SeeTheTrainer.com


Becker Orthopedic Appliance Co.Troy, Mi248/588-7480 [email protected]

Bio-Mechanical Composites Inc.des Moines, ia515/[email protected]

BioQuest Prosthetics LLCBakersfield, ca661/[email protected]

BioSculptor Corp.hialeah, fl305/556-5815 [email protected]

Bort-Swiss Orthopedic Supplyanderson, sc864/[email protected]

Boston Brace International Inc.avon, Ma508/[email protected]

Branier Custom Molded Shoessebring, fl877/[email protected]

BSN Medicalcharlotte, nc704/[email protected]

Bulldog Tools Inc.lewisburg, oh937/[email protected]

Cadence Biomedicalseattle, Wa206/[email protected]

Cailor Fleming InsuranceYoungstown, oh330/[email protected]

Cascade DAFO Inc.ferndale, Wa800/[email protected]

+Cascade Orthopedic Supply Inc.chico, ca530/879-1500 [email protected] +Center for Orthotics Design— A Fillauer Companycampbell, ca800/[email protected]

+Centri—A Fillauer Companysollentuna, [email protected] CIR Systemshavertown, Pa610/449-4879 [email protected]

COMPREHENSIVE INDEX


http://www.cailorfleming.com



College Park Industries Inc.fraser, Mi800/[email protected]

Comfort Products Inc.croydon, Pa800/[email protected]

Complete Business Solutionsamesbury, Ma888/[email protected]

Complete Professional Office Servicesfenton, Mi810/629-6424www.oandpoffice.com

Cybertech Medicalla verne, ca909/447-7050 [email protected]

DAW Industries Inc.san diego, ca800/252-2828 [email protected]

Delcamsalt lake city, uT239/[email protected]

DeRoyal Industries Inc.Powell, Tn888/[email protected]

DJO Inc.vista, ca800/321-9549 [email protected]

+ENDOLITEMiamisburg, oh800/[email protected]

Euro International Inc.Tampa, fl813/[email protected]

Fabtech Systems LLCMukilteo, Wa425/[email protected]


+Fillauer Companies Inc.chattanooga, Tn 423/[email protected]

+Fillauer LLC— A Fillauer Companychattanooga, Tn800/[email protected]

Florida Brace Corp.Winter Park, fl407/[email protected]

+FLO-TECH Orthotic & Prosthetic Systems Inc.Trumansburg, nY800/[email protected]

Freedom Innovations LLCirvine, ca888/[email protected]

Friddle’s Orthopedic Applianceshonea Path, sc864/[email protected]

Futura International Inc.anahiem, ca727/[email protected]

Grace Prosthetic Fabrication Inc.new Port richey, fl800/940-5347 [email protected]

Guard Industries Inc.saint louis, Mo800/[email protected]

HOPE Orthopedicarlington, TX407/[email protected]

+Hosmer Dorrance Corp.—A Fillauer Companycampbell, ca800/[email protected]

Innovative Neurotronics Inc.austin, TX512/[email protected]

iWalk Inc.Bedford, Ma781/[email protected]

Kingsley Manufacturing Co.costa Mesa, ca949/[email protected]

KISS Technologies LLCBaltimore, Md410/663-5477 www.kiss-suspension.com

Knit-Rite Inc.Kansas city, Ks913/[email protected]

Lawson Medical LLCvirginia Beach, va866/631-6311 [email protected]

Levy & Rappelsaddle Brook, nJ973/[email protected]

Life Like Laboratory LLCcarrolton, TX972/620-0203www.lifelikelab.comsiliconerestorations@lifelikelab.

com

COMPREHENSIVE INDEX

http://www.delcam-healthcare.com



COMPREHENSIVE INDEX

• the O&P coding expertise you’ve come to rely on is now available whenever you need it.

• Match products to L codes and manufacturers—anywhere you connect to the Internet.

• this exclusive service is available only for AOPA members.

contact Michael chapman at 571/431-0843or [email protected].

Log on to LCodeSearch.com and start today.

Not an AOPA member? GEt CONNECtEd

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EXPERt COdING AdvICE 24/7

MANUFACtURERS: Get your products in front of AOPA members! contact Joe Mcternan at [email protected] or 571/431-0811.

visit AOPA at www.AOPAnet.org.

24/7

M. J. Markell Shoe Co. Inc.Yonkers, nY914/[email protected]

Maximum Mobility Inc.san francisco, ca415/[email protected]

MD OrthopaedicsWayland, ia877/[email protected]

The MED Grouplubbock, TX800/[email protected]

Med Spec (ASO)charlotte, nc704/[email protected]

Medex International Inc.Burtonsville, Md301/[email protected]

Medi USAWhitsett, nc336/449-4440www.mediusa.comsalesandmarketing@

mediusa.com

MICA Corp.longview, Wa360/[email protected]

Mike’s Medicalclinton, oK888/[email protected]

+Motion Control— A Fillauer Companysalt lake city, uT801/[email protected]

Motion Medical Inc.Pelham, al205/982-1511 [email protected]

Mueller Sports Medicine Inc.Prairie du sac, Wi608/643-8530www.muellerrx.combrett.mueller@muellers-

portsmed.com



Nearly Me Technologies Inc.Waco, TX254/662-1752 [email protected]

New Options Sportsdallas, TX800/[email protected]

Nora Systems GmbH Shoe ComponentsWeinheim, [email protected]

Northwood Inc.center line, Mi586/[email protected]

O&P 1 Central FabricationWaterloo, ia800/[email protected]

O&P Billing Solutions Inc.Murfreesboro, Tn615/217-9821 [email protected]

O&P Business News/SLACK Inc.Thorofare, nJ856/848-1000 [email protected]

O&P EDGE/Western Media LLCnorthglenn, co303/255-0843 www.oandp.com /[email protected]

oandp.comGainesville, fl352/[email protected]

OpalStar Strategiesatlanta, Ga206/[email protected]

OPTEC USA Inc.lawrenceville, Ga888/982-8181 [email protected]

Orfit Industries AmericaJericho, nY516/[email protected]

Ortenlyon, [email protected]

Orthocare Innovationsoklahoma city, oK800/ 672-1710www.orthocareinnovations.commstanfield@orthocareinno

vations.com

Orthofeetnorthvale, nJ201/[email protected]

Orthomerica Products Inc.orlando, fl800/[email protected]

Orthotic & Prosthetic Group of America (OPGA)Waterloo, ia800/[email protected]

Össur Americas Inc.foothill ranch, ca949/[email protected]

+OTS Corp.—A Fillauer CompanyWeaverville, nc800/[email protected]

Ottobock Plymouth, Mn800/328-4058 www.ottobockus.comusa.custerservice@

ottobockus.com

Parker Hannifin Corp.cleveland, oh216/[email protected]

PEL Supply Co.cleveland, oh216/[email protected]

PFS Med Inc.eugene, or541/[email protected]

Pilgrim Shoes Baltimore, Md410/[email protected]

Pine Tree Orthopedic Inc.livermore falls, Me207/[email protected]

Professional Technologies International Inc.northborough, Ma866/[email protected]

Prosthetic Design Inc.clayton, oh800/459-0177 www.prostheticdesign.combcarpenter@prosthetic

design.com

Prosthetic Orthotic Center of New EnglandPortland, Me207/[email protected]

Proteordijon cedex. france+011-33-380-784-285www.proteor.comht.orthopedie@proteor.com

Provel Inc.cle elum, Wa509/[email protected]

PSL Fabricationfulton, Mo573/[email protected]

Quality Outcomesfredericksburg, va540/412-1429 www.qualityoutcomes.orgcustomerservice@qualityout

comes.com

COMPREHENSIVE INDEX

http://www.nora-shoe.com



PATIENT # 586-294-7950 120302-1234-01DR. LIMBMAN, CP

CODE NUMBER L5986-L5987

Soleus®(dynamicus footus)

653g

275 lb. (max wt.)CAUTION: MAY BE HABIT FORMING

The soleus is true energy in motion.SIDE EFFECTS MAY INCLUDE:Improved gait and increased comfort.Strong desire to walk rather than drive.

Sudden urges to explore uneven

surfaces and bound off-road.Bouts of uncontrollable joy.

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PATIENT # 586-294-7950 120302-1234-01DR. LIMBMAN, CP

CODE NUMBER L5986-L5987

SoleusSoleus®®(dynamicus footus)(dynamicus footus)

653g

275 lb. (max wt.)CAUTION: MAY BE HABIT FORMING

The soleus is true energy in motion.SIDE EFFECTS MAY INCLUDE:

SIDE EFFECTS MAY INCLUDE:Improved gait and increased comfort.Strong desire to walk rather than drive.

Sudden urges to explore uneven

surfaces and bound off-road.Bouts of uncontrollable joy.

SCAN QR CODE FORMORE INFORMATION

www.college-park.com/soleus

the cure for the common foot.

CPI-habit-soleus-Almanac.indd 1 5/7/12 4:56 PM


+Renia GmbH. Chemische FabrikKoeln, [email protected]

Restorative Care of America Inc.st. Petersburg, fl800/[email protected]

Roden Leather Co. Inc.royal oak, Mi800/[email protected]

Royal Knit Inc.lees summit, Mo800/[email protected]

RX Textiles Inc.Monroe, nc704/[email protected]

Silipos Inc.niagara falls, nY800/[email protected]

SoleTech Inc.salem, Ma877/[email protected]

+Spinal Technology Inc.West Yarmouth, Ma800/[email protected]

SPSalpharetta, Ga800/[email protected]

ST&G USA Corp.Placentia, ca 714/[email protected]

SteeperUSAsan antonio, TX210/481-4126www.rslsteeper.comrichard.shapcott@

rslsteeper.com

SureStepsouth Bend, in877/462-0711 [email protected]

Symmetry Prostheticsdothan, al334/793-5462www.symmetryprosthetics.com

Syncor Ltd.Green Bay, Wi920/435-1199 [email protected]

Tamarack Habilitation Technologies Inc.Blaine, Mn763/[email protected]

Texas Assistive Devices LLC Brazoria, TX979/[email protected]

TiMED Inc.Torrance, ca310/212-1232 [email protected]

Top Shelf OrthopedicsTracy, ca209/[email protected]

Touch Bionicshilliard, oh614/[email protected]

Townsend DesignBakersfield, ca661/837-1795 [email protected]

TRS Inc. (Therapeutic Recreation Systems Inc.)Boulder, co303/444-4720 www.oandp.com /[email protected]

Truform Orthotics & Prostheticscincinnati, oh513/271-4594www.saibrands.comcustomerservice@saibrands.

com

+TrulifePoulsbo, Wa888/[email protected]

Vibrant Commercial Technologies Inc.hunt valley, Md800/439-3040www.vibrantcommerce.comdandre.lewis@vibrant

commerce.com

+Vorum Research Corp.vancouver, Bc800/[email protected]

+WillowWoodMount sterling, oh740/[email protected]

Yale Surgical Company / Yale Comfort Shoe Centernew haven, cT203/[email protected]

COMPREHENSIVE INDEX



http://www.pacmedical.com





Increase exposure and save!Place your classified ad in the O&P Almanac and online on the O&P Job Board at jobs.AOPAnet.org and save 5 percent on your order. BONUS! Online listings highlighted in yellow in the O&P Almanac.

clASSIFIED RATESClassified advertising rates are calculated by counting complete words. (telephone and fax numbers, email, and Web addresses are counted as single words.) AOPA member companies receive the member rate. member nonmemberWords Rate Rate50 or fewer words $140 $280 51-75 words $190 $38076-120 words $260 $520121 words or more $2.25 per word $5.00 per word

Specials: 1/4 page, color $482 $678 1/2 page, color $634 $830

Advertisements and payments need to be received approxi-mately one month prior to publication date in order to be printed in the magazine. Ads can be posted and updated at any point on the O&P Job Board online at jobs.AOPAnet.org. No orders or cancellations are taken by phone.

Ads may be faxed to 571/431-0899 or emailed to [email protected], along with a VISA or MasterCard number, the name on the card, and the expiration date. typed advertise-ments and checks in U.S. currency made out to AOPA can be mailed to P.O. Box 34711, Alexandria, VA 22334-0711. Note: AOPA reserves the right to edit Job listings for space and style considerations.

responses to O&P box numbers are forwarded free of charge. Company logos are placed free of charge.

JOB BOARD RATESVisit the only online job member nonmemberboard in the industry at Rate Ratejobs.AOPAnet.org! $80 $140

- North Central

- Northeast

- Mid-Atlantic

- Southeast

- inter-Mountain

- Pacific

find your region on the map to locate jobs in your area.

Inter-Mountain

Director, clinical ServicesAustin, TexasThe director, clinical services, is a certified prosthetist responsible for clinical and quality management programs including: professional review of orthotic & prosthetic services (PROPS), utilization review accreditation commission (URAC) accreditation, quality management committees, and credentialing. Directly reporting to the director, clinical services, are PROPS program director, senior manager credentialing, and URAC coordinator. This individual is directly responsible for coordinating quality management program and meeting URAC accredi-tation requirements. Performs all duties of the chief case reviewer for PROPS. Works with direct reports to create and implement work flows to meet efficiency requirements; write standard operating procedures for all functions of responsibility; and support organizational goals.

Essential Functions:• Ensures policies, practices, and procedures comply with

administrative, legal, and regulatory requirements• Participates in developing and implementing Linkia’s

strategic direction for clinical operations and programs• Performs all duties of chief case reviewer—PROPS

program clinical lead• Consults with all constituents (internal and external) as

clinical expert• Oversees credentialing and compliance functions• Coordinates quality management program and

documents—QI/UM/credentialing plan, QI indicators, QI committees

• Writes SOPs for all areas of responsibility as appropriate• Performs other duties as assigned.

Required Skills and Abilities:• Demonstrated ability to lead and manage through

influence and change• Strong interpersonal skills emphasizing flexibility

and diplomacy• Exceptional presentation and public speaking skills• Strong analytical and creative problem-solving skills• Ability to prioritize and manage multitask functions• Knowledge of Microsoft Office Suite• Excellent time management, organization, prioritization,

research, analytical, negotiation, communication (verbal and written), and interpersonal skills

Required Credentials:• 5-10 years of clinical experience as certified prosthetist (CP)• Education: BA/BS• 3-5 years of supervisory/management experience preferred

If interested, please contact Mike Phelan in confidence.

Email: [email protected]: www.hanger.com/careers

JOBS



JOBS

Orthotist

Springdale, AR

Denver, CO

Thornton, CO

Springfield, IL

Urbana, IL

Louisville, KY

Grand Rapids, MI

Columbia, MO

Jackson, MS

Spartanburg, SC

Parkersburg, WV

Waukesha, WI

Prosthetist

Chico, CA Brunswick, GA

Prosthetist / Orthotist

San Francisco, CA

Stockton/Sacramento,CA

Denver, CO

North Haven, CT

Naples, FL

Pensacola, FL

Buffalo, NY

Mooresville, NC

Mayfield Heights,OH

Portland, OR

Sevierville, TN

Austin, TX

Houston, TX

San Antonio, TX

Certified Pedorthist

Lafayette, CO Roseburg, OR

AVAILABLE POSITIONS

Inter-Mountain North Central

certified Prosthetist/OrthotistCorpus Christi, TexasImmediate opening for CPO with experience. Based in Corpus Christi, Texas, with minimal travel to satellite offices. Must be ABC-certified and licensed by the state of Texas. Competitive compensation package! Please send resume to Barbie Baker at:

Fax: 361/888-7424Email: [email protected]

lab managerLouisianaWell-established O&P lab for central fab and next door pa-tient care facility. Our operation is clean, organized, modern, well-lit, and spacious. Our candidate is a good teacher and communicator who listens well, is flexible and creative, and has an eye for detail. We have evolved beyond getting

“stuff” out fast and want to focus on exceptional work within a structured schedule. Generous salary and benefits are given. If you seek a warm climate, warm atmosphere, and cooperative staff, contact Theresa or Henry.

Phone: 800/448-6676Email: [email protected]

certified Orthotist, certified Orthotist/Prosthetist, or Board-Eligible Orthotist/ ProsthetistAdvanced OrthoPro Inc. is looking for experienced COs, CPOs, or board-eligible CO/CPOs to join our busy practice. Applicants must be highly motivated and outgoing. AOI offers a competitive salary commensurate with experience and a great benefits package. Please email resume to Mohamad Mansoori.

Email: [email protected]


certified Orthotist/certified FitterLong Island/New York CityWe are a well-established practice offering an excellent opportunity for a driven person with a positive attitude. We offer benefits including 401(k), health, and profit sharing. Send resume to:

O&P Ad 0611c/O: The O&P Almanac

330 John carlyle Street, Ste. 200Alexandria, VA 22314

Fax: 571/431-0899

certified Orthotist, certified Orthotist and Board-Eligible Prosthetist, or certified Prosthetist/OrthotistNew York StatePrivately owned and growing multisite ABC-accredited P&O practice in upstate New York is seeking a certified orthotist with a minimum of two years of experience and/or a certified orthotist and board-eligible prosthetist, or certified prosthetist/orthotist. We are looking for individuals with strong orthotic backgrounds, and we may entertain an NCOPE prosthetic residency if needed. Our offices in the historic and scenic Hudson Valley and Catskill Mountains of New York are located from Saratoga to Poughkeepsie, with immediate openings in Kingston and Poughkeepsie. The ideal candidate must be self-motivated and a team player, possess good communication and technical skills, and be willing to excel for performance-based objectives. Competitive salary and benefits package offered. Submit resume to:

David misener, cPOclinical Prosthetics & Orthotics, llc


cPO, cP, cO, c.Ped, and Technician New JerseyCareer opportunity for highly motivated New Jersey licensed CPO, CP, CO, C.Ped, and technician in our many locations throughout New Jersey. Pro-Fit offers a compre-hensive benefits package that includes a competitive salary commensurate with experience; an IRA plan; health, prescription, and dental; long-term and short-term disability; and life insurance. Possible ownership oppor-tunity for qualified practitioner. Submit your confidential resume to:


Northeast

JOBS

Pacific

certified/new Jersey licensed (or Eligible) OrthotistNew JerseySeeking a self-motivated, dedicated, patient-oriented orthotist who is certified/licensed or eligible for licensure in New Jersey. We are a fast-growing company in South Jersey with endless opportunities for the right person. We offer a competitive salary/benefits package. Responsibilities will include hospital calls, detailing physicians and therapists, providing in-services, and marketing. South Jersey offers an exciting array of activities from the beaches of the Jersey Shore to the nightlife of downtown Philadelphia and every-thing in between. Please contact Allison at:

Phone: 267/433-1073Email: [email protected]

certified Prosthetist/OrthotistSouthern CaliforniaReputable, well-established, multi-office Southern California O&P facility has an immediate opening for an experienced CPO. Candidates must be self-motivated and possess strong clinical, organizational, and communication skills with excellent patient care and interaction. Must also have confidence with physician/therapist interaction. We offer a competitive salary and benefits.Email: [email protected]

certified Prothetist or certified Prothetist/OrthotistBend, Oregon Growing western states O&P business seeking a certified prothetist or certified prothetist orthotist in Bend, Oregon. Unlimited business opportunities available in an expanding local market. Competitive salary, benefits and profit sharing as the business grows.

Interested parties should email inquiries/resume to:


Visit www.AOPAnet.org for updates on events and education.

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★ Save the Date ★

Save the Date ★

Mark your calendar to attend the country’s largest, oldest, and essential meeting for orthotic, prosthetic, and pedorthic professionals.

For information about the show, scan the QR code above with a code reader on your smartphone or simply visit www.AOPAnet.org.

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Place To Be!

Join us at the AOPA 2012 National Assembly and NE Chapter combined meeting at the Hynes Convention Center in Boston. The Place to Be for learning, networking, and exhibits.

• Superior Clinical Education featuring the best speakers from around the world

• Advanced Business Programs to ensure your success during uncertain economic times

• Practical Learning and live demonstrations

• Networking with an elite and in� uential group of O&P professionals

• Preparation for the massive changes that health care reform is sure to bring

• Learn the latest rules, regulations, and Medicare billing changes needed to serve your patients

• Largest Display of O&P exhibits in the United States

• Earn more than 34 CE Credits

• Ideal Location in the heart of one of America’s most historic cities. Four miles from Logan Airport and blocks from the � nancial district, Charles River, trendy Newbury Street, and Fenway Park.

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Earn more than 34 CE credits!


■n YEAR-ROUnD TESTInGMultiple Choice Examinations. BOC has year-round testing for Multiple Choice Examinations; candidates can apply and test when ready. Orthotist and prosthetist candidates can take the Clinical Simulation Examination in February, May, August, and November. Applications are accepted any time, although seating is limited. For more information, visit www.bocusa.org or email [email protected].

■n On-SITE TRAInInGMotion Control Inc. On-site Training Course is focused on the expedited fitting of your first patient. Course Length: 3 days, CEUs: 19.5 hours (estimated). Recommended for prosthetists with a patient ready to be fit immediately. For more information, call 888/696-2767 or visit www.UtahArm.com.

2012■n JUnE 9

Ultraflex: Pediatric UltraSafeGait™ Continuing Education Course, via WebEx, 9–10 am Et. Covers assessment of pediatric pathological gait and influencing shank kinematics with the new Adjustable Dynamic Response™ (ADR™) technology. Presenter: Keith Smith, CO, LO, FAAOP. Contact 800/ 220-6670. Register at www.ultraflexsystems.com.

■n JUnE 13 AOPAversity Audio Conference—Improving Your Bottom Line. For more information, contact Stephen Custer at 571/431-0876 or [email protected].

■n JUnE 13Ultraflex: Pediatric Spasticity Continuing Education Course, via WebEx, 5–6 pm Et. Covers clinical assessment of the pediatric neuromuscular patient with spasticity and using R1 and R2 for determining orthotic design for maintaining and improving muscle length. Presenter: Keith Smith, CO, LO, FAAOP. Contact 800/220-6670. Register at www.ultraflexsystems.com.

■n JUnE 13WillowWood: discover LimbLogic® vS via WebEx, 1:30 pm Et. Critical components and operation discussed. Covers interpreting feedback from fob and basic fabrication processes for system. Credits: 2.5 ABC/TBD BOC. To register online, visit www.willowwoodco.com.

■n JUnE 14WillowWood: LimbLogic® vS for technicians via WebEx, 1:30 pm Et. Learn essentials of elevated vacuum socket fabrication using available socket adaptors with LimbLogic VS. Learn how to deal with airtight issues, unit operation, and diagnostics that will keep the system optimal for patient use. Credits: 2.5 ABC/TBD BOC. To register online, visit www.willowwoodco.com.

■n JUnE 26Ultraflex: Adult UltraSafeStep® Continuing Education Course, via WebEx, Noon–1 pm Et. Focuses on normalizing adult pathological gait with the utilization of Adjustable Dynamic Response™ (ADR™) knee and ankle technology. Presenter: Mark DeHarde or Marc Kaufman, CPO. Contact 800/220-6670. Register at www.ultraflexsystems.com.

■n JUnE 28Ultraflex: Complex Orthopedic Rehabilitation Continuing Education Course, via WebEx, Noon–1 pm Et. Focuses on Ultraflex combination dynamic and static stretching orthosis for addressing complex orthopedic rehabilitation goals and restoring range and function. Presenter: Jim Rogers, CPO, FAAOP. Contact 800/220-6670. Register at www.ultraflexsystems.com.

■n JUlY 10-12WillowWood: OMEGA® tracer® training. Mt. Sterling, OH. This hands-on class covers both orthotic and prosthetic software tools, scanner applications and tasks, ‘by measurement’ shape creation, advanced tool usage, and creating custom liners. Attendees work with patient models. Must be current OMEGA Tracer facility to attend. Credits: 18.5 ABC/18.5 BOC. To register online, visit www.willowwoodco.com.

■n JUlY 11 AOPAversity Audio Conference—Perfecting the Intake Process. For more information, contact Stephen Custer at 571/431-0876 or [email protected].

■n JUlY 24AOPA Coding Clinic. Baltimore. BWI Airport Marriott. To register, contact Stephen Custer at 571/431-0876 or [email protected].

■n JUlY 26 Arizona AFO: the Custom AFO Workshop. Philadelphia. This course covers AFO selection, coding, hands-on casting, and footwear/modification tips. Fee includes lectures, handouts, and lunch. Approved for 6.5 ABC CE credits. For details, call 877/780-8382 and mention the “Workshop” or email [email protected].

CALENDAR

■n PROmOTE EVEnTS In THE O&P ALMANAc

CALENdAR RAtEStelephone and fax numbers, email addresses, and websites are counted as single words. refer to www.AOPAnet.org for content deadlines.

WORdS Member Rate Nonmember Rate

25 or less .................. $40 .................................$5026-50 ........................ $50 .................................$6051+ .................. $2.25 per word ...............$3.00 per word

Color Ad Special:

1/4 page Ad ............. $482 .............................. $6781/2 page Ad ............. $634 .............................. $830

BONUS!listings will be placed free of charge on the Attend O&P Events section of www.AOPAnet.org.

Send announcement and payment to: O&P Almanac, Calendar, P.O. Box 34711, Alexandria, VA 22334-0711, fax 571/431-0899, or email [email protected] along with VISA or MasterCard number, the name on the card, and expiration date. Make checks payable in U.S. currency to AOPA. Note: AOPA reserves the right to edit Calendar listings for space and style considerations. For information on continuing education credits, contact the sponsor.

Questions? email [email protected].

http://www.UtahArm.com

http://www.UtahArm.com

http://www.ultraflexsystems.com/



http://www.willowwoodco.com







CALENDAR

■n JUlY 26WillowWood: LimbLogic® vS Applications Practitioners Course. Mt. Sterling, OH. Course covers various clinical aspects of LimbLogic VS applications: static and dynamic socket fitting, vacuum pump configurations, fob operation, system evaluation, liner options, alignment, and troubleshooting. Credits: 7.0 ABC/6.75 BOC. Registration deadline is July 5. Contact 877/665-5443 or visit www.willowwoodco.com.

■n JUlY 27WillowWood: LimbLogic® vS Applications technicians Course. Mt. Sterling, OH. Learn all aspects of fabricating LimbLogic VS for various applications: socket materials, controller configurations and care, fob operation, and troubleshooting. Fabricate sockets following recommended techniques for airtight socket designs. Credits: 9.75 ABC/TBD BOC. Registration deadline is July 5. Contact 877/665-5443 or visit www.willowwoodco.com.

■n AUGUST 3-4texas Chapter of the American Academy of Orthotists and Prosthetists: Annual Meeting. Austin. Sheraton Austin Hotel at the Capitol. Contact Robb Walker at 325/793-3480, email [email protected], or visit www.txaaop.org.

■n AUGUST 6-7 AOPA: Essential Coding & Billing Seminar. Hyatt at Olive 8, Seattle. To register, contact Stephen Custer at 571/432-0876 or [email protected].

■n AUGUST 13-18ABC: Certification Exams. ABC certification exams will be administered for orthotists, prosthetists, pedorthists, orthotic fitters, mastectomy fitters, therapeutic shoe fitters, and orthotic and prosthetic technicians. The application

deadline for these exams is June 1. Contact 703/836-7114, email [email protected], or visit www.abcop.org/certification.

■n AUGUST 15 AOPAversity Audio Conference–the Ins and Outs of Advance Beneficiary Notices (ABNs). For more information, contact Stephen Custer at 571/431-0876 or [email protected].

■n AUGUST 24-26National Pedorthic Services. Milwaukee. A hands-on approach to footwear modifications. Credits: 19.25 CEPs. Contact Nora Holborow at 414/438-6662, email [email protected], or visit www.npsfoot.com.

■n SEPTEmBER 1ABC: Application deadline for Certification Exams and Clinical Patient Management (CPM) Exams. Applications must be received by Sept. 1, 2012, for individuals seeking to take the November 2012 ABC certification exams for orthotists, prosthetists, pedorthists, orthotic fitters, mastectomy fitters, therapeutic shoe fitters, and orthotic and prosthetic technicians or winter CPM ABC exams for orthotists and prosthetists. Contact 703/836-7114, email [email protected], or visit www.abcop.org/certification.

■n SEPTEmBER 6-9 AOPA National Assembly & NE Chapter Combined Meeting. Boston. Hynes Convention Center. The 2012 AOPA National Assembly will be held jointly with the NE Chapter Meeting. Please plan to join us for this significant event. Exhibitors and sponsorship opportunities available: Contact Kelly O’Neill at 571/431-0852 or [email protected]. To register, contact Stephen Custer at 571/431-0876 or [email protected].

■n SEPTEmBER 12 AOPAversity Audio Conference–How to Get Paid for Orthopedic and diabetic Shoes. For more information, contact Stephen Custer at 571/431-0876 or [email protected].

■n SEPTEmBER 20Arizona AFO: the Custom AFO Workshop. Long Beach, CA. This course covers AFO selection, coding, hands-on casting, and footwear/modification tips. Fee includes lectures, handouts, and lunch. Approved for 6.5 ABC CE credits. For details call 877/780-8382 and mention the “Workshop” or email [email protected].

■n SEPTEmBER 21-23National Pedorthic Services. Milwaukee, WI. A hands-on custom foot orthosis fabrication course. Credits: 18.25 CEPs. Contact Nora Holborow at 414/438-6662, email [email protected], or visit www.npsfoot.com.

■n OcTOBER 4 Arizona AFO: the Custom AFO Workshop. Houston, TX. This course covers AFO selection, coding, hands-on casting, and footwear/modification tips. Fee includes lectures, handouts and lunch. Approved for 6.5 ABC CE credits. For details call 877/780-8382 and mention the “Workshop” or email [email protected].

■n OcTOBER 10 AOPAversity Audio Conference–What Every O&P Facility Needs to Know About the FdA. For more information, contact Stephen Custer at 571/431-0876 or [email protected].

■n OcTOBER 19-20University of Michigan Orthotics and Prosthetics Center: Centennial Celebration and Education Seminar. Making a difference for 100 years, providing service, education, and research in O&P. For details

and information about registration, visit www.med.umich.edu/pmr/op/index.htm.

■n nOVEmBER 7-9New Jersey Academy of Orthotists & Prosthetists 2012 Annual Meeting. Atlantic City. Bally’s Hotel and Casino. For details, contact Lisa Lindenberg at 973/609-2263 or visit www.njaaop.com.

■n nOVEmBER 12-17ABC: Certification Exams. ABC certification exams will be administered for orthotists, prosthetists, pedorthists, orthotic fitters, mastectomy fitters, therapeutic shoe fitters, and orthotic and prosthetic technicians. The application deadline for these exams is Sept. 1. Contact 703/836-7114, email [email protected], or visit www.abcop.org/certification.

■n nOVEmBER 14 AOPAversity Audio Conference–Medicare Enrollment Procedures. For more information, contact Stephen Custer at 571/431-0876 or [email protected].

■n DEcEmBER 2012ABC: Orthotic Clinical Patient Management (CPM) Exam. The application dead-line for this exam is Sept. 1. Contact 703/836-7114, email [email protected], or visit www.abcop.org/certification.

■n DEcEmBER 1ABC: Certification Exam Application deadline. Applications must be received by Dec. 1 for individuals seeking to take the winter 2013 ABC certification exams for orthotists, prosthetists, pedorthists, orthotic fitters, mastectomy fitters, therapeutic shoe fitters, and orthotic and prosthetic technicians. Contact 703/836-7114, email [email protected], or visit www.abcop.org/certification.



http://www.txaaop.org



http://www.abcop.org/certification



http://www.npsfoot.com




http://www.npsfoot.com

http://www.njaaop.com/

http://www.njaaop.com/











■n DEcEmBER 12 AOPAversity Audio Conference–Are You Ready for the New Year? 2013 New Codes and Policies. For more information, contact Stephen Custer at 571/431-0876 or [email protected].

2013■n JAnUARY 2013

ABC: Prosthetic Clinical Patient Management (CPM) Exam. The application deadline for this exam is Sept. 1, 2012. Contact 703/836-7114, email [email protected], or visit www.abcop.org/certification.

■n FEBRUARY 20–2339th Academy Annual Meeting & Scientific Symposium. Orlando. Caribe Royale Orlando. Contact Diane Ragusa at 202/380-3663 x208 or email [email protected].

■n mARcH 15-16PrimeFare West Regional Scientific Symposium 2013. Denver. Denver Marriott City Center. Contact Jane Edwards at 888/388-5243 or visit www.primecareop.com.

■n SEPTEmBER 18-21O&P World Congress. Orlando. Gaylord Palms Resort. Attend the first U.S.-hosted World Congress for the orthotic, prosthetic, and pedorthic rehabilitation profession. To register, contact Stephen Custer at 571/431-0876 or [email protected]. a

CALENDAR

company Page Phone website

Advanced O&P Solutions 17 (866) 914 AOPS www.aopsolutions.com

Allard USA inc. 23 (888) 678-6548 www.allardusa.com

ALPS 11, 53 (800) 574-5426 www.easyliner.com

American Board for certification in

Orthotics, Prosthetics & Pedorthics 19 (703) 836-7114 www.abcop.org

Becker Orthopedic 33 (800) 521-2192 www.beckerorthopedic.com

cascade Dafo 38 (800) 848-7332 www.cascadedafo.com

college Park industries inc. 69 (800) 728-7950 www.college-park.com

custom composite 2 (866) 273-2230 www.cc-mfg.com

DAw industries 1, 71 (800) 252-2828 www.daw-usa.com

Dr. comfort 5, c3 (800) 556-5572 www.drcomfortdpm.com

DYcOR 13 www.dycormfg.com

Friddle’s Orthopedic Appliances 59 (800) 369-2328 www.friddles.com

Hersco Ortho Labs 9 (800) 301-8275 www.hersco.com

KiSS technologies LLc 39 (410) 663-5477 www.kiss-suspension.com

KNit-RitE 25 (800) 821-3094 www.knitrite.com

Med Spec 31 800-582-4040 www.medspec.com

Motion control 34 (888) 696-2767 www.utaharm.com

OPtEc 14, 15, 40, 41 (888) 982-8181 www.optecusa.com

Orthomerica Products 37 (800) 446-6770 www.orthomerica.com

Orthotic and Prosthetic Study

and Review Guide 35 www.oandpstudyguide.com

Össur® Americas inc. 7, c4 (800) 233-6263 www.ossur.com

Otto Bock Healthcare c2 (800) 328-4058 www.ottobockus.com

PEL Supply company 27 (800) 321-1264 www.pelsupply.com

See the trainer 65 (402) 493-4747 www.SeeTheTrainer.com

willowwood insert (800) 848-4930 www.willowwoodco.com

AD INDEX





http://www.primecareop.com


AOPA ANSWERS

AOPA receives hundreds of queries from readers and members who have questions about some aspect of the O&P industry. Each month, we’ll share several of these questions and answers from AOPA’s expert staff with readers.

if you would like to submit a question to AOPA for possible inclusion in the department, email Editor Josephine Rossi at [email protected].

Grounds for AppealAnswers to your questions regarding ultra-light material codes and concentric-style torsion joints


Q. I am receiving Medicare denials for the ultra-light material codes (l5940-l5960)

when they are billed with preparatory base codes. I have reviewed the lower-limb Prosthesis lCD and Policy Article, and these codes are not included in the list of codes that will be denied as not medically necessary when billed with an initial or preparatory prosthesis. Why is Medicare denying these codes?

A. For many years, policy stated that the ultra-light material codes were only to be used to

describe ultra-light components of a prosthesis that did not include the socket. Effective with the Policy Article dated April 1, 2010, CMS reversed its opinion on the use of the ultra-light codes and stated that they were only to be billed when material used in the fabrication of the socket was ultra-light in nature.

CMS also issued instructions to the DME MACs that advised them to create system edits that only allowed codes L5940-L5960 to be billed in conjunction with definitive base procedure codes and socket replacement codes. These instructions are most likely the cause for the denial of the ultra-light codes when billing a preparatory device.

You are correct, however, that the current Lower-Limb Prosthesis LCD and Policy Article do not prohibit billing for ultra-light material when providing a preparatory base code. This fact estab-lishes grounds for an appeal based on the argument that policy does not indicate that ultra-light materials are not medically necessary when used in the fabrication of a preparatory prosthesis.

Q. Can I bill Medicare for a concentric-style torsion joint provided with a custom or

prefabricated orthosis?

A. The answer is yes, but how you code for it and bill for it will depend on the function of

the joint. If the concentric adjustable torsion joints are used solely to provide an assistive function for joint motion, you may use the L2999 code for a lower-extremity orthosis and L3999 for an upper-extremity orthosis.

If the concentric-style torsion joints are used for any other purposes and are incorporated into the item you are providing, it is no longer considered an orthosis; it is considered to be a DME item and must be coded and billed using one of the following codes:

• E1800—Dynamic adjustable elbow extension/flexion device

• E1802—Dynamic adjustable forearm pronation/supination device

• E1805—Dynamic adjustable wrist extension/flexion device

• E1810—Dynamic adjustable knee extension/flexion device

• E1815—Dynamic adjustable ankle extension/flexion device

As a reminder, any claim for an L2999 or L3999 must include either a narrative description of the item or the manufacturer name and model name/number. a

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june 2012 almanac

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