If the pt has not seen the physican in 1 1/2 yrs... yes the pt should see the physician again. I would assume a carrier would not pay for the DME if the pt has not been seen and evaluated for continued medical necessity of the brace.
If the pt lost the brace, you should check with the insurance carrier first before dispensing and billing. Therefore if the carrier refuses payment for a replacement, you can inform the pt before receiving the brace that he/she would be responsible and what the fee would be.
Have a good one!
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