Prosthetic Components FAQ
- Information for clinicians
- What do I need to know?
- Which forms and clinical criteria do I use?
- How do I know the supplier code for the product?
- What if the available contract items do not meet the person’s clinical needs?
- What if my client does not want to change their prosthetic components when they receive a new limb?
- Roll-on Liners are on the Standard List – how will these be funded?
- Will there be any change to invoicing practices?
- For more information
Information for clinicians
The following information is provided as a guide to understanding the use of NSW Government Contract HSSP_HC19_PLC849 Prosthetic Components.
EnableNSW has appointed a panel of suppliers for prosthetic components. Components available to use for people eligible for EnableNSW are listed on an approved components list.
The process for component supply under this contract remains the same:
- Prosthetic Service Providers (PSPs) choose the most appropriate components for a person’s needs from the standard list and according to the Prosthetic Limb Service (PLS) Funding Guidelines
- PSPs seek prior approval from EnableNSW for discretionary items available on the non-standard list
- PSPs purchase components directly from the contracted supplier
- Contracted suppliers organise delivery directly to the PSP
- PSPs invoice EnableNSW for components used in the prosthetic limb.
What do I need to know?
The NSW Government Contract HSSP_HC19_PLC849 will be available from 27 March 2020.
- The items on this contract provided by EnableNSW include prosthetic limb components and consumable items.
- In the first instance, prescribers should select suitable products from the contract Standard List:
- If these items are not clinically suitable, then items from the Non-Standard List of components may be considered.
- To request an item from the contract Non-Standard List, complete the regular prosthetic request form as well as the Discretionary Request Form providing clinical rationale for the non-standard item.
- Quotes are not required for contract items.
- You may notice some changes to the products provided by EnableNSW:
- Some brands or components are not available on the contract and are therefore no longer provided by EnableNSW.
- The ‘Standard List’ of prosthetic components and consumables items is available for all consumers.
- A ‘Non-Standard List’ of prosthetic components and consumable items is available for discretionary requests only, and approval of items from this list is at the discretion of EnableNSW.
- The PLS Funding Guidelines have been adjusted consistent with the introduction of a standard and non- standard list and increase in the minor repair prior approval amount to $700. Annual allocations have not changed.
- Clinicians requesting Microprocessor Knee’s (MPK), or with any other questions should contact EnableNSW PLS clinical advisor to discuss additional requirements.
Which forms and clinical criteria do I use?
Download the forms and check the funding guidelines and clinical criteria relevant to the type of prosthesis being requested. Please do not save or print local copies of forms and guidelines as regular updates are made.
For a prosthesis using products from the contract Standard List, use the regular prosthetic request forms. These products do not require special approval and are available to all eligible people.
To request an item from the contract Non-Standard List, complete the regular prosthetic request form as well as the Discretionary Request Form providing rationale for the non-standard item.
How do I know the supplier code for the product?
What if the available contract items do not meet the person’s clinical needs?
If you are unable to find a suitable component on the contract, EnableNSW will consider requests for non- contract items within our clinical criteria.
Non-contract products will only be provided in the event that there are no items on contract to meet a person’s specific clinical need. For example, modular components rated over 226kg are not available on Contract HPLC849 and can be provided on request for people requiring these types of components.
What if my client does not want to change their prosthetic components when they receive a new limb?
EnableNSW is required to order products from the government contract. Non-contract products will only be provided in the event that there are no items on contract to meet a person’s specific clinical need.
If a person does not wish to change products where a clinically appropriate item is available on contract, they may choose to self-purchase directly from their PSP.
Roll-on Liners are on the Standard List – how will these be funded?
The Roll-on Liners and Locking Devices on the Standard List are priced similarly to the previous PLS process for roll-on liner funding. You may fit any of these items on the Standard List and invoice at the contract price. Replacement liners will be funded at the contract price.
If a person requires a different type of liner that is not on the Standard List, you may request a non-contract liner using a Discretionary Request Form with full clinical rationale.
Will there be any change to invoicing practices?
When invoicing to the PLS, PSPs are required to itemise the supplier product code from the contract for each product used in a prosthetic limb. Many of the product codes are now individual codes, not family codes.
For more information
Phone: 1800 362 253 (1800 Enable)