Dear Colleagues,
We are already over a week into April and it is shaping up to be a very busy month. Our Legislative Affairs Committee met this past Monday to review NYSPMA’s agenda for the next few weeks as the legislature reconvenes next week. Our Lobby Day teams are being finalized for April 25 and we are excited to see so many NYSPMA members signing on to participate this year along with several NYCPM students. We are asking members to contact their respective legislative offices to ask for support of the Scope and Business Law Bills. This will strengthen our visits on Lobby Day and the follow up meetings that will take place. We have included talking points here that you can use for your conversations and meetings. Please consider making a donation to NYPPAC by filling out the form found here. By making a donation, you will be eligible for a $2,500 prize. We thank you for your contributions which help NYSPMA in our lobbying and advocacy efforts.
The NYSPMA Officers met last night followed by the NYSPMA Board Meeting at the New York College of Podiatric Medicine today. Plans are on the way for the NYSPMA HOD at the Mohonk Mountain Resort, New Paltz. Dr. Paul Liswood, as President-Elect, is working on his transition.
Podiatric student recruitment is important to the future of our profession. The AACPM and the DPM Mentors Network have created materials for promoting careers in podiatric medicine, including a college information booklet, a student brochure, foot pens, Mentors Network stickers, and cell phone wallets. Whenever you request resources for your office or attend a student recruitment event, the AACPM will provide these materials to you. Additionally, you can still help the AACPM reach their goal of 500 mentors. Sign up to become a mentor here. NYSPMA has signed up several new mentors for the AACPM during the past few months. Thank you. The future of our profession will be more secure with strong mentors, just as many of us have had strong mentors early in our careers so it’s important to play it forward to thank those who mentored us along the way.
The APMA resource page has been updated with the most current info from CDC as well as other entities on Opioids. We’ve had questions from several members about guidelines that they could use. Here's the most current link to the APMA resource page on Opioids. As you know, Opioid use reduction and the critical impact podiatrists can have on reducing opioid addiction is one of the key focus areas of NYSPMA’s Population Health White Paper.
We continue to receive numerous calls at the office with individual requests to assist members with billing, coding, and insurance questions. NYSPMA’s policy is that all questions for assistance in these areas need to go through the web portal. Our Insurance Committee Chair, Dr. Nicholas D'Angelo and our consultants constantly monitor the portal and work quickly to provide responses for members. Questions and responses on the portal benefit all NYSPMA members.
Have a wonderful rest of your week.
Patricia
Emblem Health/HIP System Issue Denial!
April 10, 2018
Recently claims submitted to Emblem/HIP are being rejected with code CO-234: This procedure is not paid separately.
After speaking with the insurance supervisor, it was confirmed that this is a system issue. They have also not put this issue in their website.
In order to rectify this, you will need to have your billers call and have the claims reprocessed until they fix their system issue.
Additionally, as of 01/01/18 HIP members have a new ID# which starts with “K’
Upcoming Member Partner Programs and Updates
Don’t forget to visit our Member Partner Program section on our website to take advantage of the numerous savings opportunities for members. Our benefit partners include medical insurance, travel, entertainment and dining packages, car rentals, business supplies, risk management, coding and reimbursement insurance and practice billing solutions. We also have our benefits listed in a brochure developed by our Membership Committee.
Call for Bylaw Amendments and Resolutions
BYLAWS: The deadline for submitting bylaw amendments for consideration at the 2018 NYSPMA House of Delegates is Friday, April 20. Please submit with the Bylaw Revisions Form. Questions regarding the resolution process can be sent to William Pierce, wpierce@nyspma.org. All proposed revisions should be typed onto the Bylaw Revisions Form and submitted by email.
RESOLUTIONS: The deadline for submitting resolutions for consideration at the 2018 NYSPMA House of Delegates is Tuesday, May 15. Please submit with the Resolution Form. Questions regarding the resolution process can be sent to Daniel Keating, keating06@aol.com. All proposed resolutions should be typed onto the Resolution Form and submitted by email.
NYSPMA Awards Call for Nominations
Many of our members donate countless hours to the Podiatric profession. They work tirelessly to advance and promote the profession with no expectation of personal gain. We are asking for your help to identify these individuals by submitting nominations for awards, allowing us to recognize those who are deserving.
For complete information on each award, eligibility and to nominate someone online, click here. If you would like a printable version of this information, click here.
If you need assistance, please feel free to contact us at (212) 996-4400.
Additional Procedures Now Require Prior Approval
Please refer to each of the dated hyperlinks below for more information about requirements that will affect your practice.
CPR Billing and Coding Tip of the Week
To assist you and your staff in keeping up to date with insurance, billing and coding changes, we have added this new Tip of the Week feature. Each week, we will be providing a “tip” to help you navigate the increasing complexity of reimbursement and compliance. We encourage you to visit our Billing and Coding Portal.
New “K” Code for Therapeutic Shoe Inserts
CMS recently revised Appendix C of the DMEPOS Quality Standards to include a new type of therapeutic shoe insert for individuals with diabetes that is fabricated without molding it to beneficiary-specific physical positive model. The revisions allow the use of direct carving (milling) using a Computer-Aided Design/Computer Aided Manufacturing (CAD-CAM) or similar system, without the creation of a physical positive model, as a custom fabricated therapeutic shoe insert manufacturing technique falling under the scope of the Therapeutic Shoes Part B benefit. To facilitate implementation of this new category of therapeutic shoe inserts, the following new code will be added to the HCPCS code set effective April 1, 2018:
K0903: For diabetics only, multiple density insert, made by direct carving with CAM technology from a rectified CAD model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer or higher), includes arch filler and other shaping material, custom fabricated, each.
Effective for claims with dates of service (DOS) on or after April 1, 2018, K0903 must be used for Medicare billing of all manufactured/centrally fabricated custom fabricated inserts that are produced by direct milling (carving) manufacturing. For direct-carved inserts currently coded as A5513, K0903 must be used for claims submitted to Medicare with DOS on or after April 1, 2018, regardless of their current listing on the A5513 Pricing, Data Analysis, and Coding (PDAC) contractor’s Product Classification List. For claims with DOS on or after April 1, 2018, and before August 1, 2018, the requirement for product listing on the PDAC Product Classification List for HCPCS code K0903 is waived for all manufacturers/central fabricators only if a completed coding review application has been submitted to the PDAC. The waiver is effective from the date of application through July 31, 2018. For claims with DOS on or after August 1, 2018, only therapeutic shoe inserts listed on the PDAC Product Classification List for K0903 may be billed to Medicare using HCPCS code K0903. Claims billed using K0903 for unlisted products after August 1, 2018, are incorrectly coded. HCPCS code A9270 (NON-COVERED ITEM OR SERVICE) must be used to bill for unlisted custom fabricated therapeutic shoe inserts.
CMS reminds suppliers to use the KX modifier on all claims for K0903 when all requirements in the medical policy are met. The billing jurisdiction for this code is the DME MAC. Please note that reimbursement is also the same, $87.12 per pair and $261.36 for three pairs.
Please note that providers are receiving official notices sent by the suppliers regarding the use K0903 and the correct way to code based on how the inserts are made. Please note that proper billing/coding is tied to the fabrication completed by the supplier not by the provider at the office. Additionally, this only applies to A5513 “custom technique” and A5512 remains the same.
Become a Mentor for a Young Podiatrist
Serving as a mentor is typically more rewarding for the mentor than the mentee and NYSPMA President, Patricia Nicholas, DPM, knows how much she has personally grown from serving as a mentor. Become a mentor today and promote Podiatry as a career choice at AACPM's DPM Mentors Network. As of today, there over 700 undergraduate students enrolled in the Network and nearly 350 Mentors and Speakers. AACPM’s Goal is to reach 500 mentors by the end of 2018 and need your help!
NYSPMA Job Board
For most, seeking a new career takes a lot of time and patience. Job hunting has turned into a science. Avoid wasting your time and patience by using the right resources to find your next career. The NYSPMA Job Board is the best channel to find open positions in our industry. Recruiters posting on the NYSPMA Job Board are looking for quality candidates that stand out from the rest. Be sure to upload your resume and start searching the open positions posted on the NYSPMA Job Board today. Click here to get started!
NYSPMA: Connect on Facebook & Twitter
NYSPMA has a Facebook page and is now on Twitter. These pages provide Association announcements and updates. We are always looking for great news stories to share on our pages. If you’ve recently been quoted in the media, received an award, launched a new project or have relevant news to share, please email lsales@nyspma.org.
Poster for Your Office: We have developed an 8 1/2 x 11 Full Color Poster/Flyer that can be displayed in your office to encourage your patients to visit our site to stay up to date on the latest foot health news and get updates on diabetes, bunions, heel pain...and more.
