Live Webinar: Medicare Lower Limb Prostheses Prior Authorization and PDAC updates

Hosted by Lesleigh Sisson

About the webinar

Medicare recently introduced six lower limb prosthetic HCPCS to the existing prior authorization program. This webinar will outline the basics of the program and how it will affect O&P suppliers for compliance purposes. In addition, most of these prior auth LLP codes will also now require PDAC coding verification as of January 1, we’ll review what this means and what suppliers may need to do in preparation for this change.

Will cover:

  • Prior Authorization for LLP Codes: We’ll identify the six HCPCS codes being added to the prior authorization program and what process will need to be followed to be compliant with Medicare Prior Authorization.
  • Documentation requirements: A high-level overview of the required documents for a successful prior authorization including their individual required elements.
  • What we have learned so far: Prior Authorization for these six HCPCS was introduced September 1. 2020 for four select states and as a result we’ve learned some tips for successful prior authorization submission.
  • How to avoid non-affirmed decisions: The most important part of prior authorization for a supplier is an affirmed PAR, so we’ll discuss what NOT to do when submitting a prior auth to increase the odds of an affirmed authorization.
  • PDAC updates (January 1, 2001 Requirements): Information about what a PDAC coding verification for the affected codes means to O&P suppliers. 
  • Resources and Reminders: Links and tips related to the information reviewed in today’s webinar. We recommend saving/bookmarking these resources for future reference.