PATIENT REFERAL

How to Refer Patients

At West New York O&P, our mission is to ensure seamless and timely orthotic and prosthetic care from the moment you refer your patients to the final delivery of their devices. We value the importance of communication throughout the referral process, making it easy for you and your patients to receive the care they need. We keep you informed and committed to reporting patient outcomes, allowing you to celebrate their successes along the way.

Click to learn about 5 simple steps to refer a patient

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REFERRAL STEPS

Five Simple Steps to Refer Your Patients to West New York O&P Clinic

  • Send a prescription to the West New York O&P Clinic, including the necessary diagnosis codes and any supporting notes.

  • Your patient contacts our clinic to schedule a complimentary evaluation.

  • We evaluate your patient and verify their insurance benefits.

  • Our certified orthotist and prosthetist will fabricate and/or fit the prescribed device according to your patient's needs.

  • Your patient is scheduled for a follow-up visit, and we will report the outcomes back to you, ensuring you are up to date on their progress.

Documentation Best Practices for Prosthetic Referrals

Accurate and detailed documentation is crucial for payer compliance and ensuring a smooth referral process. Please follow these best practices for all prescriptions and medical records.

  • To ensure compliance, all documentation must clearly connect the diagnosis, its cause, and the resulting condition.

    • Provide Both Codes & Narratives: Always include the specific ICD-10 code and its full descriptor narrative.

    • Establish a Direct Connection: Clearly link the diagnosis, its underlying cause, and the patient's condition. For example:

      • Trauma: "Partial traumatic amputation of the left lower leg resulting from a motor vehicle accident."

      • Disease: "Amputation secondary to gangrene caused by a non-healing diabetic foot ulcer."

      • Congenital: "Congenital absence of the right forearm."

    • Ensure Consistency: The cause, condition, prescription, and all clinical notes must consistently support the ICD-10 codes you have chosen.

  • Your notes should include a comprehensive patient history. Use this checklist to ensure all key points are covered.

    • Patient Demographics:

      • Current age

      • Age at limb loss

    • Amputation Details:

      • Level (e.g., AKA, BKA) and side (left/right)

      • Etiology (cause of amputation)

    • Prosthetic Readiness:

      • Status of medical comorbidities (e.g., CHF, renal disease, arthritis)

      • Emotional and cognitive readiness for safe prosthetic use

    • Physical Examination:

      • General cardiopulmonary status

      • Description of the unaffected limbs (note any scars, wounds, edema, etc.)

      • Specific description of the limb to receive the prosthesis (including length, incision status, and overall readiness for fitting)

  • Your assessment and plan should provide a clear justification for the recommended device and outline future care.

    Address Functional Impact

    Clearly describe the patient's current functional problems and how the prescribed device will help, especially in the context of their other medical conditions.

    • Example 1: "This patient has a history of congestive heart failure (CHF), and the reduced cardiac function may limit mobility if not accommodated with the appropriate lightweight prosthesis."

    • Example 2: "This patient has end-stage renal disease and is on hemodialysis, so volume fluctuations in the residual limb may occur and require prosthetic adjustments."

    • Example 3: "This patient has extensive arthritis in the right lower extremity, which must be considered for stability and alignment when using a left AKA prosthesis."

  • Reference any discussions with other healthcare providers that contributed to your decision-making.

    • Example: "The above recommendations were formulated with input from the patient's prosthetist, who was also in agreement."

  • Delineate your plan for managing comorbidities that could impact the patient's function with their prosthesis.

    • Example: "Medical comorbidities will be re-evaluated on an ongoing basis in coordination with the patient's primary care physician and prosthetist."