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Linda Collins Blogger

Documenting Functional Levels

Posted by Linda Collins | February 07, 2019

A lower limb prosthesis may be covered when there is documentation to support the patient will reach or maintain a specific functional level. The documentation must be corroborated in the physician's medical records. Simply stating the K level and definition is not sufficient. Your documentation and the physician's documentation must list the activities and details that allow a review to determine functional level.

A patient's functional level is based upon the evaluation of the prosthetist and treating physician. The assessment may include, but not be limited to,

  • a review of the patient's past medical history

  • prior prosthetic use

  • assistive devices used and when

  • the patient's current medical condition

  • co-morbidities

  • the condition of the residual limb

  • symptoms limiting ambulation

  • description of activities of daily living and how impacted by limb loss

  • gait

  • balance/coordination

  • strength

  • and the patient's desire to ambulate

A Physician Worksheet for Prosthetic Documentation, which a tool to use when communicating documentation needs to the treating physician, may be downloaded under the Reimbursement Resource section of this page.

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