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1.7. Prosthetic Funding Management
In order to monitor, maintain and continually improve the fiscal accountability of prosthetics funding, all VA facilities will submit a budget plan by quarter each fiscal year to local designated management official for approval. This plan will be reviewed by the financial staff of the VISNs and PSAS Program officials to develop and implement a quarterly funding and workload analysis to monitor all prosthetic cost centers. The budget plan should be based on historical expenditures and projected need.
a. General Costing Instructions by Cost Center
(1) 8272 - Prosthetic Program. Includes cost for new and repair prosthetic equipment, appliances, devices, etc., for patients.
(2) 8201 - Medical. The cost of surgical implants (for the device only) when performed by Medical Service personnel, e.g., cardiac pacemakers, defibrillators, etc. NOTE: Do not include the cost of related items or equipment, e.g., sutures, staples, clips, pliers, etc.
(3) 8202 - Surgical. The cost of surgical implants (for the device only) when performed by Surgical Service personnel, e.g., artificial hips, knees and other joints, heart valves, galvanic nerve stimulators, dorsal column stimulators, intra-ocular lenses, vascular prostheses, bladder neck prostheses, etc.
(4) 8265 - Denver Distribution Center. Includes the cost incurred for hearing aids; hearing aid batteries, parts and accessories; prosthetic stump socks; prosthetic feet; flexible orthoses, etc.
(5) 8266 - Orthopedic Shoe Service. Includes the cost of centralized orthopedic shoe program (VA Medical Center, New York, NY, National Footwear Center only).
(6) 8273 - Orthotic Laboratories. Includes the cost of materials and components used in the fabrication of orthotic and/or prosthetic devices and prefabricated devices custom fitted to the patient (limited to VHA Headquarters-approved Prosthetic-Orthotic Laboratories).
(7) 8274 - Restoration Clinic. Includes the cost of materials used in the fabrication of cosmetic restorations, e.g., artificial eyes, ears, noses, etc., and supplies (limited to VA Central Office approved Restoration Clinics).
(8) 8211 - Dialysis. Include the charges for home dialysis activities only when provided by services other than Prosthetics.
(9) 8364 - Contract Dialysis. Include the costs for supplies and equipment when provided under contract through Medical, Surgical, or Prosthetic Services. NOTE: Do not duplicate costs charged under Cost Center 211 and 272.
b. General Costing Instructions by BOC
(1) 2551 - Prosthetic Contractual Services. Includes repair and all contractual agreements and services required to provide prosthetic appliances, sensory aids, cosmetic restorations and sickroom accessories and equipment; veterinary treatment for guide dogs; repairing and reweaving of clothing damaged by wearing of prosthetic appliances, and is restricted to services furnished beneficiaries.
(2) 2574 — Home Oxygen Program. Includes the cost of home oxygen contractual agreements, rental fees for concentrators, portable systems, and cylinder contents or liquid contents.
(3) 2674 — Oxygen Supplies. Includes the purchase cost of oxygen equipment and supplies for home oxygen use.
(4) 2692 - Prosthetic Supplies. Includes the cost of all aids, appliances, parts or accessories which are required to replace, support, or substitute for a deformed, weakened, or missing anatomical parts of the human body. This includes complete prosthetic appliances, sensory aids, stump socks, hearing aid batteries, cosmetic restorations, medical accessories, dental maxillofacial prostheses and related implants and raw materials used in the fabrication or repair of such items. All prosthetic devices implanted in the patient; includes cardiac pacemakers, heart valves, artificial joints, intra-ocular lenses, prosthetic arteries, penile implants, medication pumps, neurostimulators, etc., are to be costed to Cost Center 8201 or 8202 under this sub-account.
(5) 2693 - Home Dialysis Equipment and Supplies. Includes the cost of dialysis equipment and recurring prosthetic supplies provided to veterans under the Home Dialysis Program.