4.5.38 Prostheses & orthoses (external)
The Agent can pay the reasonable costs of external prostheses and orthoses when required as a work-related An injury/disease is work related if it arose out of or in the course of employment and the scope of employment. injury or illness.
Policy
Refer to policy for External Prostheses & Orthoses including information about:
- who can provide prosthetic and orthotic services
- what costs will be paid for
- what information is require to pay for serviced.
See: Fee Schedule for External Prostheses & Orthoses
Prior approval
- prior approval is not required for orthoses and prostheses costing under $250
- prosthetists/orthotists do not require a request from a medical practitioner to provide prosthetic/orthotic devices (but an initial referral from a medical practitioner is required)
- this policy and work practice does not apply to surgically implanted prostheses. Refer to the Surgically Implanted Prostheses policy. Normally requests for surgically implanted prostheses are treated under the Elective Surgery policy. For ‘gap permitted prostheses’ – refer to a Medical Advisor for clinical justification.