CPO Documentation, Coding & Reimbursement

Question 1

Which documentation element is required by Medicare to establish medical necessity for an orthotic or prosthetic device?

Accepted Answer

Physician's detailed written order (Certificate of Medical Necessity)

Answer

Patient's insurance card copy

Answer

CPO's personal recommendation letter

Answer

Hospital discharge summary only

Question 2

In the SOAP note format used in O&P documentation, what does the 'S' stand for?

Accepted Answer

Subjective

Answer

Summary

Answer

Systematic

Answer

Surgical

Question 3

Which document authorizes a CPO to legally fabricate and dispense a specific prosthetic or orthotic device?

Accepted Answer

Physician's prescription or detailed written order

Answer

Insurance pre-authorization only

Answer

Physical therapist's referral note

Answer

CPO's independent clinical assessment

Question 4

How long must O&P providers retain patient records to comply with Medicare requirements?

Accepted Answer

5 years from date of service

Answer

3 years from date of service

Answer

7 years from date of service

Answer

10 years from date of service

Question 5

Which elements must be included in a clinical note documenting a prosthetic fitting to demonstrate medical necessity?

Accepted Answer

Functional limitations, device specifications, patient response, and follow-up plan

Answer

Only the device serial number and delivery date

Answer

Insurance information and payment history only

Answer

Manufacturer warranty information and cost breakdown

Question 6

What is the purpose of the Advance Beneficiary Notice (ABN) in O&P practice?

Accepted Answer

To notify Medicare beneficiaries of potential non-coverage and their financial responsibility

Answer

To obtain prior authorization from Medicare before fabrication

Answer

To document patient allergies to prosthetic materials

Answer

To request a second medical opinion from another physician

Question 7

Which document confirms that an orthotic or prosthetic device was delivered to a patient and is required for billing?

Accepted Answer

Delivery confirmation or receipt signed by the patient

Answer

Certificate of Medical Necessity

Answer

Insurance claim form CMS-1500

Answer

Referral authorization from the physical therapist