HomeVA ProstheticsVA Handbook 1173.11 - Ocular Prostheses and Facial RestorationsProcedures for Furnishing Appliances

11.4. Procedures for Furnishing Appliances

a. VA Restoration Clinics

(1) VA Restoration Clinics must be used as the primary source for restorative items whenever the patient is able to travel and the distance to be traveled is not excessive. The referring physician must make these determinations after communicating with the patient, and the patient family members for input. Travel exceptions need to be based on medical and/or clinical limitations, supported by the referring physician, and documented in the patient treatment file and/or electronic consult.

(2) Patients requiring ocular prostheses, orbital prosthesis, implants, facial and body restorations, cosmetic gloves for partial hand amputations, prostheses, etc., may be referred by any VA facility to the nearest VA Restoration Clinic.

(a) Cosmetic gloves for partial or complete hand amputees may be fabricated by a Restoration Clinic if commercially available sources are not adequate. Such prostheses are made available to any veteran upon receipt of an OWL.

(b) Functional prosthetic devices, for use by partial or complete hand amputees requiring an opposition post or other modification, must be fabricated by an Orthotic Laboratory prior to requesting a cosmetic glove. The cast of the patient's hand and the device fabricated are to be forwarded to the selected procurement source for the glove whenever an initial cosmetic glove is requested.

(3) When a custom prosthesis or repair is authorized, use the following instructions:

(a) An OWL must be prepared electronically and forwarded, by the most expeditious means, to the clinic selected with documentation of eligibility for VA medical care and a Health Information Network Query (Eligibility Verification Form).

(b) A separate OWL must be prepared for each beneficiary for whom the prosthesis is to be fabricated or repaired. NOTE: Two or more items for a beneficiary may be included on a single request form.

(c) The referring facility must retain an OWL in suspense, identifying the preparing office pending delivery of the prosthesis, and notification that the patient is satisfied with the completed product or repair.

(d) Field facilities requiring the services of a Restoration Clinic located at another facility need to coordinate the scheduling and obtain confirmation of an appointment prior to referring beneficiaries or sending an OWL to the clinic.

(e) The Restoration Clinic must document the patient's record by creating a progress note into the Computerized Patient Record System (CPRS) describing each visit and what was done during the visit. All electronic consults and suspense items must be completed and closed upon issuance of the cosmetic device or repair.

(f) All patient appointments for services provided by the Restoration Clinic must be scheduled through the Appointment Management menu in the Veterans Health Information System and Technology Architecture (VistA).

(4) The receiving facility initiates an OWL, identifying the referring facility in the appropriate section of the OWL; then the completed OWL is transmitted to the referring site.

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