HomeVA ProstheticsVA Handbook 1173.1 - Prosthetics EligibilityDefinitions

1.3. Definitions

a. Access Points (Outpatient Clinic). Medical facilities authorized in treating eligible beneficiaries outside of regular VA medical center settings. Includes the outpatient clinic of a regional office; independent VA outpatient clinic; and an outpatient clinic of a VA medical center.

b. Advisory Committee on Prosthetics and Special-Disabilities Programs. An advisory committee to the Secretary of Veterans Affairs established by Pub. L. 102-405 to provide advice concerning prosthetics for spinal cord injured veterans, blind veterans, veterans who have loss or loss of use of extremities, hearing impaired veterans and other veterans with serious incapacities in terms of daily life functions.

c. Aids For the Blind. Any device, equipment, or animal used in assisting a legally blind beneficiary in overcoming the handicap of blindness, to include guide dog, low vision aids, tools, utensils, mechanical or electronic items designed especially to overcome the handicap of blindness.

d. Amputee Clinic Team. A team of professionals responsible for the overall rehabilitation of amputee patients, e.g., pre- and post-operative counseling of the amputee, training in, preparation for, and use of artificial limbs, prescription and inspection of artificial limbs, followup activities, etc.

e. Appliance (device, item, etc.). Generic term used in referring to all prosthetic appliances, aids for the blind, and medical equipment.

f. Automobile Adaptive Equipment (AAE). Items and/or devices necessary to permit safe operation of, or permit access to and egress from an automobile or other conveyance.

g. Commission on Accreditation of Rehabilitation Facilities (CARF). Independent survey entity which accredits rehabilitation health care facilities.

h. Chief Medical Officer. The physician in charge of treatment at an outpatient clinic or outpatient care services at a VA medical center.

i. Clothing Allowance. An annual sum of money, specified by Congress, to be paid to each veteran who because of a service-connected disability wears or uses a prosthetic or orthotic appliance (including a wheelchair) which tends to wear out or tear the outer garments of clothing of said veteran; or uses medication which a physician has prescribed for a skin condition which is due to a service-connected disability determined by the Secretary to cause irreparable staining damage, or destruction from the necessity of frequent laundering to the veteran's outer garments. These provisions are applicable to 38 U.S.C. 1151 veterans.

j. Code of Federal Regulations (CFR). The CFR is the annual cumulation of executive agency regulations published in the Daily Register, combined with regulations issued previously that are still in effect. It contains the general body of regulatory laws governing practice and procedure before Federal administrative agencies. These regulations are cited using the title, part and section number, e.g., Title 38 CFR 17.115.

k. Contracting Officer's Technical Representative (COTR). A technical employee of a contracting activity designated by a contracting officer and responsible for monitoring the contractor's performance to ensure compliance with technical requirements.

l. Contracting Officers Certification Program (COCP). A formal program for the selection, appointment, and termination of appointment of contracting officers. Training, experience, education, performance, and conduct are the objective criteria reviewed prior to appointment as contracting officers. The head of the contracting activity manages the COCP program at the medical facility and can appoint contracting officers with authority to award contracts up to $100,000 or to place delivery orders under existing contracts.

m. Control Point. The division of monies from an appropriation to a specified service, activity or purpose.

n. Cost Center. A series of specific numerical digits assigned to a functional or?√°organizational level for the purpose of classifying and accumulating costs applicable to that particular functional or organizational level, e.g., Prosthetics, Fiscal, Pharmacy.

o. Delayed Order. A prescription or prosthetic request that the local Prosthetic Service is unable to administratively process or take action on within 5 workdays.

p. Denver Distribution Center (DDC). A centralized provider of devices, accessories and repair services to eligible veterans when requested by the health care facility with Primary Service Area (PSA) responsibility wherever the beneficiary may reside or sojourn; this includes certain replacement items at the veteran's request, and distribution of selected devices, accessories or services to other VA programs or activities as designated. Such devices, accessories or services include: selected electronic, mechanical or other aids for the blind, hearing aids, batteries for hearing aids, provision of hearing aid repairs through internal or contract sources, orthopedic software, and such other items or services which may be designated by appropriate VHA Headquarters Program Officials.

q. Disability Codes. Decision Support System (DSS) identifiers assigned to a patient for specific disabilities.

r. Durable Medical Equipment (DME). Items determined to be medically necessary for home treatment including invalid lifts, hospital beds, commodes, etc.

s. Driver Rehabilitation Centers. Facilities specifically funded and equipped to train appropriate veteran beneficiaries to drive a motor vehicle independently and in accordance with State Department of Motor Vehicle regulations.

t. Enrollment. Effective October 1, 1998, VA is required to enroll patients annually and to ensure that enrollees receive health care. Veterans seeking care for service connected disabilities, and veterans with service connected disabilities rated at least 50 percent are exempt.

u. Federal Acquisition Regulation (FAR). The primary document in FAR system contains policies and procedures contained in regulations which govern all purchasing activities for Federal agencies.

v. Federal Procurement Data System (FPDS). A mechanism of collecting, developing, and disseminating procurement data to Congress, the Executive Branch, and the private sector, as directed by Pub. L. 93-400.

w. Health Care Procedural Code (HCPC). Medicare created HCPCS, the Health Care Financing Administration's Common Procedure Coding System, for the purpose of universal cost coding. This system has been adopted by VHA as a national mechanism of common identification. The codes are assigned to appliances, devices, medical equipment and supplies provided to patients. Each code corresponds to the Health Care Financing Administration (HCFA) designated 5-digit identifier or VA-unique 5-digit identifier.

x. Home Improvement and Structural Alterations (HISA) Committee. A committee composed of professional and ancillary service personnel responsible for determining whether requested benefits are necessary and appropriate for the effective and economical home health treatment of a veteran's disability. Requests may include, but are not limited to: construction of wheelchair ramps (permanent only), widening doorways for wheelchair access, lowering kitchen cabinets or counters for use by a wheelchair patient, improve otherwise inaccessible entrance paths and driveways, etc.

y. Integrated Funds Distribution, Control Point Activity, Accounting And Procurement (IFCAP). A fiscal accounting software package that automates fiscal, budgetary, inventory, billing and payment activities.

z. Item Master File. A listing which provides a full description of the item, related stock numbers, vendors, contract numbers and a procurement history.

aa. Joint Commission on Accreditation of Healthcare Organizations (JCAHO). A national independent accreditation organization which certifies health care organizations such as hospitals as compliant with its promulgated standards.

bb. Last Clinic. Facilities established at select VA medical centers which are staffed, funded, and equipped to develop lasts, perform measurements, cast patterns, and make modifications to/for custom-made orthopedic shoes.

cc. Major Appliances. Includes all custom-made prosthetic appliances, items of medical equipment which cost more than $6,000, artificial limbs and specialty equipment, e.g., Clinitron beds, communication devices, environmental control units.

dd. Major Medical & Special Equipment Committee (MMSEC). A committee composed of medical, therapy, engineering and allied health personnel who are knowledgeable about prosthetic equipment and rehabilitation responsible for reviewing requests and determining medical need for major items of prosthetic equipment.

ee. Major Medical Special and/or Experimental Appliances. Any newly developed or unusual non-contract orthopedic appliance, therapeutic or rehabilitative device, regardless of cost, which has not been previously issued by the health care facility.

ff. Medical Supplies. Expendable items generally required on a recurring basis for home treatment of specific disabilities, including supplies required for home hemodialysis.

gg. National Prosthetics Patient Database (NPPD). A compilation of statistical data extracted from each VA medical center's entries to the prosthetics package, reflecting both fiscal obligations and completed patient transactions.

hh. Patient Satisfaction Program. A survey and analysis of patient evaluation of prosthetic services provided by the VA.

ii. Preservation Amputation Care and Treatment (PACT). Model of care developed to prevent or delay amputation through early identification of patients who are at risk for limb loss.

jj. Primary Service Area (PSA) for Prosthetic Services. A defined geographical area responsible for providing complete prosthetic services, including the administration of HISA,?√°Home Oxygen Therapy, Automobile Adaptive Equipment and Clothing Allowance Programs.

kk. Prosthetic Appliances. All aids, devices, parts or accessories which patients require to replace, support, or substitute for impaired or missing anatomical parts of the body. The items include artificial limbs, terminal devices, stump socks, braces, hearing aids and batteries, cosmetic facial or body restorations, optical devices, manual or motorized wheelchairs, orthopedic shoes, and similar items.

ll. Prosthetics. A broad term used to identify the total concept associated with replacing, supporting and/or complementing human anatomy impaired or destroyed as a result of trauma or disease. This term may be used to refer to orthotics, sensory aids, medical equipment, medical supplies, components, research, education and training, appliances, services, repairs, and any other related aspects of administering the total program.

mm. Prosthetic-Orthotic Laboratories. Facilities established at select VA medical centers to design, fabricate, repair and fit custom-made prosthetic appliances.

nn. Prosthetics Program. Includes any Prosthetic Treatment Center, Prosthetic and Sensory Aids Service, or section established in a VA field facility charged with the responsibility for the provision of prosthetics at that facility.

oo. Prosthetics Purchasing Agent. An employee in a VA medical center who is certified under COCP and specifically designated and trained to procure prosthetic appliances and repairs, thereof, usually at the simplified acquisition level.

pp. Prosthetics Treatment Center (PTC). A VA facility with an established Amputee Clinic Team, experienced prosthetic staff and Physical Medicine and Rehabilitation personnel capable of providing assistance necessary to resolve difficult prosthetic problems. These centers normally have a substantial number of special medical programs, i.e., Spinal Cord Injury Service (SCIS), Spinal Cord Injury Outpatient Support Clinic (SCI/OSC), Visual Impairment Services Team (VIST), Hospital Based Primary Care (HBPC), Prosthetic-Orthotic Laboratory (POL), Restoration Clinic (RC), Blind Rehabilitation Center or Clinic (BRC), Driver Rehabilitation (DR), Geriatric Research, Education and Clinical Center (GRECC), etc.

qq. Prosthetics Representative. A VA employee who is a patient advocate, manages the prosthetic program, and ensures that adequate resources are available to meet the medical needs of veterans requiring prosthetic services.

rr. Prosthetics Representative Management Trainee (PRMT) Program. An established educational experience designed to develop professionally competent personnel to conduct and manage the Prosthetic Program at a VA medical center.

ss. Prosthetic Request. An appropriately written medical prescription or electronic request by an authorized clinician, or patient's request for replacement of an issued item/service requiring action by the Prosthetic Service.

tt. VA Form 10-2501, Prosthetic Service Card (PSC). A debit-card issued to eligible beneficiaries authorizing repairs for artificial limbs, wheelchairs, braces, and aids for the blind. This card usage is limited to repairs.

uu. Prosthetic Stock Items. Any item of medical equipment, or prefabricated prosthetic appliances, or parts or components thereof, which has been procured with allocated medical funds, and which is currently stocked by a Prosthetic program for direct issue to eligible beneficiaries. This includes donated and/or reclaimed items of equipment.

vv. Prosthetic Surgical Implants. Artificial devices implanted in the patient to replace, support or substitute for deformed or weakened anatomical parts of the body, e.g., artificial hips, knees or other joints; cardiac pacemakers, heart valves, or implantable cardiac defibrillators; intraocular lenses, prosthetic arteries, penile implants, implantable nerve stimulators, etc.

ww. Purchase Card. A card similar to a credit card, with a pre-set monetary limit, used to pay for goods or services acquired by authorized and designated employees for the official VA use.

xx. Reconciliation. The process by which Integrated Funds Distribution, Control Point Authority, Accounting and Procurement (IFCAP) obligations are made compatible with invoices received for purchases initiated by a Purchase Card through the Veterans Health Information systems and Technology Architecture (VISTA) software package.

yy. Required Sources of Supplies and Services. Sources identified in Federal Acquisition Regulation (FAR) Part 8 that have priority as sources from which to acquire goods and services.

zz. Restoration Laboratory. Facilities established at select VA medical centers which custom-make artificial eyes, facial and body restorations, and similar appliances.

aaa. Sensory Aids. Items and/or devices designed to compensate for deficiencies in sense organs, e.g., hearing aids, optical prescriptions, low vision and mobility aids, speech and communication aids, etc.

bbb. Spina Bifida. A developmental anomaly characterized by defective closure of the bony encasement of the spinal cord, through which the cord and meninges may protrude.

ccc. Strategic Healthcare Group (SHG). A multidisciplinary group of personnel and programs organized generally to support the provision of a continuum of care to a specified population of patients or care in a particular setting. The SHG functions by integrating data, skills and best practices into system-wide policy, planning and service delivery through the development of clinical care strategies and decision support mechanisms.

ddd. Transaction. Any action with permanent numbering that affects a bill or an account that identifies a request; consisting of the Station Number - Fiscal Year - Quarter - Control Point Sequence Number.

eee. Vendor Master File. A listing which contains ordering and billing addresses, contract information, FPDS information and telephone numbers of businesses.

fff. Department of Veterans Affairs Acquisition Regulations (VAAR). Policies and procedures which pertain directly to procurement performed by the VA. These policies supplement FAR and will not duplicate it.

ggg. Veterans Integrated Service Network (VISN). A geographical area designated by the Department of Veterans Affairs Headquarters for the purpose of basic budgetary and planning of the veterans healthcare system. Each VISN will be led by a Director who will report to the VHA Chief Network Officer.

hhh. Visual Impairment Services Team (VIST). Health care and allied health care professionals charged with the responsibility for determining the comprehensive services required by a visually impaired veteran.

iii. Wheelchair Committee Clinic. A locally established team composed of a physician, rehabilitation therapist, and prosthetic representative charged with evaluating, refining,?√° and developing prescriptions for wheelchairs.

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