Prosthetics and orthotics information for AADL vendors

1. Create an authorization for a client who requires bilateral devices

There is a simple way of remembering how to record bilateral clients and that is 2-1-2

  • 2 lines on the "history" screen (1 for LL and 1 for LR)
  • 1 line on the authorization (Qty = 2 BL)
  • 2 lines on the claim (1 for LL and 1 for LR)

An example for bilateral clients is as follows:

  • Step 3 Update History Screen Requires two lines:
  • One line for LLAFO and
  • One line for LRAFO
  • Under the Benefit Information Screen enter:
  • One Cat # qty 2 indicate BLAFO in serial number field.
  • The claim requires two lines:
  • LRAFO in serial number field
  • LLAFO in serial number field

2. Authorize a catalogue number for one side for bilateral clients

As long as the client history has the two lines pertaining to the bilateral device, you can enter in your catalogue number on Step 5 as a quantity of "1" and then put in the serial number for the affected side (i.e. LLAFO).

3. Put the correct devices in the serial number field of the claim

Refer to the Orthotic Grouping Table for the catalogue numbers for each device.

4. Error message "CAT # NOT VALID FOR ORTHOTIC DEVICE"

If you get this error message when creating an authorization, look up the catalogue number in the Orthotic Grouping Table to ensure it is under the correct device.