Feature
L-Codes: Are They Meeting the Needs of O&P?
By Miki Fairley
Regardless of your view toward the United States L-Code system and its reimbursement methodology, there is no arguing that the system is complex, as shown by the plethora of coding seminars, manuals, and software available to help navigate its maz...
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Feature
L-Codes: What's Wrong? What's Right?
By Judith Philipps Otto
L-Codes make great scapegoats. According to many practitioners, the woes of the world begin and end with L-Codes. But while the United States unique O&P reimbursement system has some flaws, and some cracks have appeared in its foundation over time...
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Feature
L-Code Obstacles: Experience from the Front Lines
By Gerald Stark, CPO/L, FAAOP, Beth Stiner, C.Fom
Two O&P professionals discuss the four main obstacles to dealing with the Centers for Medicare & Medicaid Services (CMS) Healthcare Common Procedure Coding System (HCPCS) Coding Committee and the Statistical Analysis Durable Medical Equipment Regi...
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Perspective
Amazing Technology—But Not for Everyone
By Edgy
I admit it. When it comes to all this new prosthetic technology, my "edge" is a little dull. Still, I keep hearing about it in the news.
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Sports
NASCAR Meets Accessible Racing
By Morgan Stanfield
Brian Hanaford felt sorry for himself. He had his reasons. After a serious head injury ended his career as a champion runner, he was temporarily paralyzed and spent years slowly reclaiming everyday abilities.
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Stepping Out
Foot Orthotic Biomechanics, Part II
By Séamus Kennedy, BEng (Mech), CPed
In the May 2008 issue of The O&P EDGE, I provided an overview of early foot-orthotics theory, as well as a brief history of arch supports. Seminal work by Merton Root, DPM, on the relationship of the subtalar joint (STJ) to the midtarsal joint, n...
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Today's Consumer
Gary Ashe: Modifying the Perfect Fit
By Chelan M. Keeter
Gary Ashe knows what it means to put his life at risk. In 1969, at the age of 19, Ashe was sworn into service as an Army reservist by his father, Major Charles J. Ashe.
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Face to Face
Five Questions for Alfred 'Denny' Denison, CLP
At 84 years old Alfred Denison, CLP, may be the oldest practicing prosthetist in the United States. Though he was drafted into the military before graduating from high school, his attention to detail, dedication to patient mobility, and six decade...
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Got FAQs?
Got FAQs?
By Lisa Lake-Salmon
Whether you have a question about L-Codes, documentation, or claim denials, count on Got FAQs? to help keep your O&P shop running smoothly. Q: Recently, you published a question that was directed at additions to L-1845.
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Industry Review
CAPO Covers the Future of O&P
The Canadian Association for Prosthetics and Orthotics (CAPO) welcomed delegates, presenters, and exhibitors to Winnipeg, Manitoba, for its 16th annual conference, held June 18-21. There were 175 delegates in attendance, who were met by 150 exh...
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Industry Review
ACA's 2008 Annual Conference Is One for the Record Books
Shortly after the 2007 Amputee Coalition of America (ACA) annual conference , the ACA announced that its president and CEO, Paddy Rossbach, RN, would be retiring early in 2008. Rossbach kicked off the 2008 conference, held June 19-22 at the Renais...
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Progress on Parity
Summer Fun...Parity Style
By Morgan Sheets
As the weather heats up, so does the fight for prosthetic parity. Many activists are using this time to increase the momentum behind the Amputee Coalition of Americas (ACA) initiatives to pass legislation that will create a consistent standard for...
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Viewpoint
Knowledge Is the Best Defense
By Karen Henry
L-Code. I've counted the letters,and it's not a four-letter word although you might think it is if you bring it up in conversation with your O&P colleagues. Conversations about L-Codes evoke groans, grimaces, and heavy sighs from Medicare-weary pr...
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EDGE Direct Sponsored Story
Expulsion Valve Now Includes Vacuum Valve
Velocity Labs has expanded its new Velocity Expulsion Valve toinclude a vacuum hookup valve. The new Vacuum Valvehousing fits into the existing VMP-007 mounting plate and allows avacuum tube to connect to the socket through a 3/8-in. spacerplated...
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Otto Bock's Helix3D
7E10 is the first hip joint with hydraulic stance- and
swing-phase control. The Helix3D
provides pelvic rotation and a greater flexion angle, giving users
more natural gait patterns and increased freedom of movement.
The Helix's three-dimensional movement mimics
the human hip joints natural and symmetrical gait pattern. Its
polycentric design allows for leg length reduction during swing
phase, which reduces the risk of falling and increases
function.
Because the hip joint offers a larger flexion angle of 130
degrees, it is easier to accomplish activities of daily living such
as putting on shoes or getting into a car.
Otto Bock HealthCare
800.328.4058
www.ottobockus.com

Fresh wounds from amputation surgery can become
infected. Using the antibacterial version of the
OrfitransTM Stiff material as a
temporary socket dramatically reduces the amount of bacteria on the
socket surface, thereby reducing the risk of bacteria entering the
wound. Customers will now be able to get the outstanding
performance characteristics of Orfitrans Stiff
with the significant benefits of an antibacterial component that
will effectively inhibit bacteria growth.
Friddles Orthopedic Appliances
800.528.9339
www.friddles.com

A new, modern design approach inspired us to
combine the conveniences of a modular system with the rigidity and
lightweight characteristics of composites to create a laminated
system that is user friendly to the practitioner.
Components can be easily detached from the orthosis and adjusted
for ease of fitting, adjustment, and replacement. The laminated
sections of the orthosis are now fabricated around the metal
components and attached with screws.
This cosmetically appealing orthosis system has a streamlined
design and is lightweight. The typical KAFO weighs only 2.6 lb.
Becker Oregon
800.866.7522
www.beckerorthopedic.com

Medi USA's M.4® OA knee
brace is designed to protect, stabilize, and ease the pain caused
by unilateral osteoarthritis and all indications requiring pressure
relief. The M.4 OA provides pressure relief of the
medial or lateral joint compartment by a well-cushioned,
three-point relief system that offloads the affected compartment
into a varus/valgus position. The M.4 OA
safeguards against hyperextension by limiting flexion and
extension.
The ultra-flat, lightweight, and non-protruding Avional®
aluminum frame and Physioglide® hinge are 30 percent more
rigid and durable than other aluminum alloy technologies of the
same weight. Available in six sizes in either varus or valgus
versions. Medi USA has received favorable Medicare reimbursement
for the M.4 OA.
Medi USA
800.633.6334
www.mediusa.com

The WalkAide® is a
functional electric stimulation (FES) device for treatment of
upper-motor neuron-related foot drop. It uses sophisticated sensor
technology and FES, which stimulates the nerves that dorsiflex the
foot at the appropriate time during the gait cycle, producing a
much more natural and efficient walking pattern. There is no switch
in the patient's shoe, allowing him to even walk barefoot when
appropriate. Walking speed increases while the energy used for
walking is reduced. To learn more about the
WalkAide and how to locate the nearest
WalkAide-trained location, visit our website and
go to our facility locator page.
Innovative Neurotronics
888.884.6462
www.walkaide.com

OMEGA® Tracer® provides
the ability to capture patient shapes and create AFOs. The
OMEGA Scanner allows clinicians to quickly and
accurately capture patient shapes in several ways:
- Scanning a one-part negative cast.
- Scanning a two-part negative cast.
- Scanning a patients foot and foot impression.
- Directly scanning a patients foot and calf.
OMEGA Tracer software makes modifying patient
shapes intuitive and easy. Clinicians may also create personalized
AFO modification wizards. OMEGA Tracer AFO files
may be used with in-house carvers or sent to external central
fabrication facilities. Contact us for a free in-facility
demonstration.
Ohio Willow Wood
800.848.4930
www.owwco.com

The new e-2 Electric Elbow,
manufactured by Hosmer®, is now available from PEL Supply.
Compared to previous elbows, the new e-2offers the
following benefits:
- Lifting power increased by 37.5%.
- Energy efficiency increased by 40%.
- 47% faster.
- Free swing at full extension.
- Lightweight and extremely quiet.
- Interchangeable with E-200 and E-400 conventional elbows.
- Exoskeletal or endoskeletal application.
- Full electric power at the cost of a European hybrid.
PEL Supply Company
800.321.1264
www.pelsupply.com
A Revolution in Clubfoot Treatment

Matthew Dobbs, MD, designed this new
dynamic clubfoot bar to allow active movement,
preserve muscle strength in the foot and ankle, and be less
restrictive to the child than traditional fixed-bars. Children
using the Dobbs Bar can crawl and kick their legs
independently. Children will sleep better because they can get
comfortable in the Dobbs Bar, and heel blisters
commonly associated with fixed-bars are no longer a problem. The
Dobbs Bar is adjustable from 8 to 14 inches to
accommodate growth; no need to buy replacement bars. The foot
plates are universal and can be attached to shoes and AFOs. The
results are better compliance, a more active child, and happier
parents.
D-Bar Enterprises LLC
314.968.8555
www.dobbsbrace.com

The PacificTM Adjustable
Collaris designed to provide your patients with effective
control of cervical spine motion. Now, when necessary, that control
can be extended with a new
thoracic extension (TE) option.
Pacific TE includes the following features:
- Intended for low cervical/high thoracic immobilization.
- Available in one height- adjustable size.
- Quickly and easily snaps on to the PacificTM
Adjustable Collar.
- Can be purchased separately or as a fully assembled CTO.
Becker Orthopedic
800.521.2192
www.beckerorthopedic.com

Coyote Design now offers fiberglass casting tape
and a number of other casting and modification
items. All these tools are designed to make casting and
modification easier and more efficient. Fiberglass casting tape is
available in 2-, 3-, and 4-in. sizes and comes in boxes of ten.
Contact Coyote for a new catalog featuring these and more new
items.
Coyote Design
800.819.5980
www.coyotedesign.com

The KX06 by Endolite is the
industry's only hydraulic swing and stance polycentric knee. The
polycentric design frame provides greater toe clearance for a more
natural and safe gait. The robust swing and stance hydraulic lets
you keep the knee where it belongs--on your patient--with fewer
maintenance issues. Multiple proximal adapter choices provide
flexibility in socket design and accommodate a wide range of
clearance options.
Other features of KX06 include:
- A convenient hydraulic exchange program.
- Distal pyramid.
- 320 lb. weight limit.
- Three-year warranty.
Endolite North America
800.548.3534
www.endolite.com

Ossur's PROPRIO FOOT® is an
artificially intelligent, motor-powered prosthesis that helps
replace the function that the body's central nervous system would
normally play.
- Sense: Using advanced motion-sensing
accelerometers, the PROPRIO FOOT can "sense" the
surroundings of each step and accommodate for action.
- Think: As fast as it measures, the data is fed
into the "brain" of the device through TerrainLogicTM,
identifying specific motions to enable a response to
variations.
- Act: Foot motion is continuously analyzed. For
each stride, gait pattern recognition algorithms in the foot are
used to detect and identify when and where a user is walking.
Ossur Americas
800.233.6263
www.ossur.com

Advancing liner technology one step further, the
new Iceross® Seal-In®
is as close as we have come to complete prosthetic attachment, with
the convenience of a simple step-in-and-go system. The new system
for transtibial users applies pure suction but does not require an
external sleeve, saving time and money.
A proprietary design with five separate seals bridges between
the residual limb and the internal socket wall. Unique seal design
conforms and clings tightly, guaranteeing suspension, rotation
control, and proprioception, while allowing for unprecedented knee
freedom. This retrofitable liner provides unmatched performance and
favorable patient outcomes, making the user more confident and
better able to perform activities.
Ossur Americas
800.233.6263
www.ossur.com

Integrating a dynamic pylon, the multiaxial
OnyxTM Foot allows active users to
demand more. Highly customizable with four degrees of
plantar-dorsiflexion Angle ControlTM and adjustable
Stride Control® for fine-tuning gait, the sleek Onyx
Foot delivers balanced energy with ideal comfort and
enhanced terrain compliance.
Key benefits of the Onyx Foot include:
- Dynamic pylon foot.
- Superior terrain compliance.
- Precision gait matched for out-of-the-box performance.
- Adjustable Stride Control to fine-tune foot stiffness from heel
strike to heel off.
- Three-year warranty.
Onyx--balanced energy, ideal comfort.
College Park Industries
800.728.7950
www.college-park.com

Have you made your AK frame and the knee is just
too close?
The Ortho Remedy Inc. now has a solution. The new AK
Spacer unit will extend the connection ½ in. from the
socket to the knee. The AK Spacer is manufactured
from lightweight aluminum and is equipped with a standard four-bolt
pattern for easy attachment.
The Ortho Remedy Inc.
800.662.7993
www.orthoremedy.com

Every leg has a different shape and skin
condition, so Allard USA now offers another choice of below-knee
interfaces for your ToeOFF® or Blue RockerTM carbon
composite AFOs. The new comfortKITTM is
a deluxe version of Allards SoftKIT. An inner layer of polyurethane
foam molds naturally to the leg, yet offers the "bounce" to return
to its original shape when not in use. Consider
comfortKIT for wearers who, due to the skins
condition, shape of the tibia, and/or activity level, would benefit
from an interface that offers added cushioning and more intimately
contours to the shape of the leg.
Allard USA
888.678.6548
www.allardusa.com

OTS Corporation has now activated
E-Commerce on its website. Customers can log on to
the OTS website and sign up for this service using their existing
account numbers. Within one business day, the customer's account
will be activated to allow online purchasing, even when the OTS
corporate office is closed. This benefits customers in later time
zones and people working after hours. The site is also available in
Spanish, French, and German. Any certified O&P professional who
does not have a customer number can call OTS's toll-free telephone
number to set up an account to use the E-Commerce
function.
OTS Corporation
800.221.4769
www.ots-corp.com

The Syncor Original TES Belt was
designed to meet the needs of clients with above-the-knee
amputations. Its user-friendly design includes a hand loop for easy
application and a replaceable Velcro® closure. The
Original TES Belt is low profile and has an
anti-roll, anti-bunch panel. Reinforced, color-matched seams extend
the life of the hand-washable belt.
The Silesian design evens out stress and eliminates the
pull-down feeling associated with girdle-style belts. A wide,
360-degree textured cuff grips with no air leaks, and a
proportional adductor panel increases suspension capabilities.
Sizes from infant to XXL. Custom orders are welcome.
Syncor Ltd.
920.435.1199

The new Black Iron Trainer is a
lighter version of the heavy-duty, high-performance Black Iron
Master. While the Black Iron Trainer is smaller
and lighter in weight, it is capable of handling the wide range of
handle diameters that are encountered in modern fitness and
exercise facilities.
The completely manual operation and positive locking and
unlocking design provides uncompromising security and stability for
bench pressing, dumbbell flys, dead lifts, pull-downs, and more.
The Black Iron Trainer, with a load-rating of 440
lb., also carries a smaller price tag than its larger cousin.
TRS Inc.
800.279.1865
www.oandp.com/trs

The dynamic Dobbs Bar allows
children to move and kick their legs independently, which gives
children with clubfoot the freedom to crawl and be more active in
the brace. Children fuss less and sleep better. Independent
movement prevents heel ulcers and keeps kids from pulling out the
booties.
The Dobbs Bar is adjustable from 8 to 14 inches
to accommodate growth--no need to buy replacement bars. The foot
plates are universal and can be attached to shoes and AFOs. The
results are better compliance, a more active, happier child, and
happier parents.
Knit-Rite Inc.
800.821.3094
New from TRS

TRS introduces a unique, adult, super-compact
(7-in. long), high-performance rock climbing foot for the
unilateral and bilateral climber. Supplied with a titanium pyramid
adapter and high traction Evolve® custom climbing shoe and a
certificate for a free, matching, custom climbing shoe of
appropriate size for the unilateral climber.
Designed and tested by nationally recognized and experienced
transtibial rock climbers, the Z-Axis was used in competition at
the 2008 Extremity Games®.
Weighing only 25 oz. with a high-strength keel and polyurethane
structural body, the Z-Axis provides superior control, loading,
leverage, and "feel" on the rock.
TRS
800.279.1865
www.oandp.com/trs

The Dycor ADL-FDS Foot features
functionality, durability, and simplicity. The foot is segmented
horizontally into five layers. The titanium foot adapter is
integrated into the advanced composite keel, minimizing socket
floor clearance. The heel portion of the keel (posterior to the
adapter) is a flexible urethane-fiberglass composite, which
deflects to cushion heel contact.
Patented and patent pending.
Dycor
800.794.6099
www.dycormfg.com

Provel offers cost-effective, fast, easy-to-use,
and reliable O&P automation. The D2 digitizer,
C5 carver, and T6 thermoformer are appropriate for small clinics as
well as large central fabs. All are AOP-file compatible and backed
by a two-year warranty. The D2 digitizer allows automated shape
capture of prosthetic casts with unmatched accuracy. The C5 carver
is not only fast and precise, its self-contained dust-collection
system is extremely quiet. The T6 thermoformer consistently
produces high-quality thermoplastic sockets from industry-standard
preforms.
Provel Inc.
509.857.2009
www.provel.us
- Immediate cash: plan your future.
- We solve business issues, allowing you to focus on your
patients.
- We are not a broker, buyout fund, or corporate CPA.
- We are well-funded, have experienced O&P management, and
are focused on creating a great company.
- If you are interested in finding a partner to run the business
side of your practice, contact us. All discussions are
confidential.

BridgePoint Medical
859.260.8576
http://bp-medical.com/page8.php