We have nothing to disclose Orthotics, Braces and Splints: Sports - PowerPoint PPT Presentation

We have nothing to disclose Orthotics, Braces and Splints: Sports Medicine DME Pearls UCSF 13 th Annual Primary Care Sports Medicine Conference Tim Baldwin, MA, ATC, CFo Amber Pryor, MS, ATC, CFo 3 Orthotics, Braces and Splints: Sports Medicine DME Pearls Overview Knee Bracing Acute vs Chronic  Knee Braces  Acute  Chronic/Functional Acute vs Chronic - T-Scope ACL  Ankle Bracing - -  Gold Standard Unloader - Acute vs Functional - Knee immobilizer -  Single vs Double Upright  Spine  Short term Patella stabilizer - Cervical vs TLSO vs LSO - Long hinged knee brace - Hinged knee brace -  Hand, Finger, and Elbow Short hinged knee brace - Sleeves - OA vs Immobilization vs - Patella stabilizer  Not covered - Chronic  Most commonly lateral Patellar tendonitis -  Nighttime Splinting control  Most not covered Wrist vs Elbow vs Feet -  Insurance Pearls 4 Orthotics, Braces and Splints: Sports Medicine DME Pearls 5 Orthotics, Braces and Splints: Sports Medicine DME Pearls 1

Ankle Bracing Ankle Bracing Acute vs Functional  Acute  Chronic/Functional CAM/FAW Figure 8 - -  Short vs Tall  Rigid and Semi-rigid  Wedging PTTD Aircast -  Balance other side Hinged ankle brace - Stirrup - Functional Foot Orthotics -  Short vs Long Leg  Custom vs OTS AFO -  Custom vs OTS Foot -  PO shoe/Heel cup/Offloader shoe 6 Orthotics, Braces and Splints: Sports Medicine DME Pearls 7 Orthotics, Braces and Splints: Sports Medicine DME Pearls Spinal Bracing Spinal Bracing Cervical/TLSO/LSO  Cervical  LSO Soft Collar Rigid panel - - Miami J Corset - - Aspen Binder - - Headmaster/Springwire  Postural -  TLSO Figure 8/Clavicle - Soft custom TLSO  Mother to Be - Backpack style Specifically for pregnancy - - 8 Orthotics, Braces and Splints: Sports Medicine DME Pearls 9 Orthotics, Braces and Splints: Sports Medicine DME Pearls 2

Hand, Finger, Elbow Hand, Finger, and Elbow Acute vs Chronic Acute vs Chronic  Acute  Chronic Jammed finger, CMC Arthritis - - dislocation, fracture, laxity  Brace doesn’t involve wrist Most treated with stack -  Moldable stays or heat splint or oval splint molded  Stack for multiple joints Elbow - - Mallet finger/avulsion  Olecranon Bursitis Fx/extensor injury - Elbow pad 24/7  Oval-8 for laxity/single joint - Spider pad suggested - PIP joint 10 Orthotics, Braces and Splints: Sports Medicine DME Pearls 11 Orthotics, Braces and Splints: Sports Medicine DME Pearls Nighttime Bracing Nighttime Bracing Wrist/Elbow/Leg  Wrist  Leg/Feet Most common carpal Plantar Fasciitis - - tunnel or DeQuervains Progressive stretching - Wrist splint vs Thumb - spica  Elbow Cubital tunnel splint - Keep in 122 degree - extension 12 Orthotics, Braces and Splints: Sports Medicine DME Pearls 13 Orthotics, Braces and Splints: Sports Medicine DME Pearls 3

BT1 What form must a patient sign if their brace Insurance Pearls is considered not medically necessary or a non-covered benefit by Medicare?  1. ABN  2. NPI  3. COF  4. CPO  5. TMI 14 Orthotics, Braces and Splints: Sports Medicine DME Pearls 15 Orthotics, Braces and Splints: Sports Medicine DME Pearls Insurance Pearls Tips and Tricks  Pain is not a diagnosis, it’s  Knee braces most a symptom scrutinized  MD notes overrule O&P State instability, even - pseudo laxity notes Download CMS lower -  If you work with an O&P extremity guide office, have them provide  Must be rigid or have in-service hinges to be billable  Must state medical  Cold therapy not covered necessity of brace  Must have seen in last  Limit use in note to 1 year year for Rx 16 Orthotics, Braces and Splints: Sports Medicine DME Pearls 17 Orthotics, Braces and Splints: Sports Medicine DME Pearls 4

Slide 14 BT1 ABN - Advanced Beneficiary Notice (3 Options) Baldwin, Timothy, 11/28/2018