Medicare Advisory Liaison

I am asking for your help with developing a list of codes/procedures performed by podiatrists in Illinois but not covered or denied by National Government Services (NGS) Medicare.

My question is: Are there any procedures that you have performed that have been denied by either Medicare or private insurance that you feel your license allows and maybe even your hospital or surgery center has credentialed you for?

Below I have included the Illinois Statute covering podiatric medicine.  As a reminder letter H defining amputations is a limit on amputations only and not on the rest of the scope (foot and ankle and the soft tissue that insert into the foot).

Please respond by August 30th 2019.

Thank you for you for your assistance.
Jeffrey Crowhurst DPM
CAC Member Illinois 

Illinois Statute

ILLINOIS COMPILED STATUTES CHAPTER 225. PROFESSIONS AND OCCUPATIONS HEALTH ACT 100. PODIATRIC MEDICAL PRACTICE ACT OF 1987 100/5. Definitions [This Act is scheduled to be repealed January 1, 2018, pursuant to 5 ILCS 80/4.28.] As used in this Act: (A) “Department” means the Department of Financial and Professional Regulation. (B) “Secretary” means the Secretary of Financial and Professional Regulation. (C) “Board” means the Podiatric Medical Licensing Board appointed by the Secretary. (D) “Podiatric medicine” or “podiatry” means the diagnosis, medical, physical, or surgical treatment of the ailments of the human foot, including amputations as defined in this Section. “Podiatric medicine” or “podiatry” includes the provision of topical and local anesthesia and moderate and deep sedation, as defined by Department rule adopted under the Medical Practice Act of 1987 [225 ILCS 60/1 et seq.]. For the purposes of this Act, the terms podiatric medicine, podiatry and chiropody have the same definition. (E) “Human foot” means the ankle and soft tissue which insert into the foot as well as the foot. American Podiatric Medical Association State Reference Manual Scope of Practice – June 2018 26 (F) “Podiatric physician” means a physician licensed to practice podiatric medicine. (G) “Postgraduate training” means a minimum one-year postdoctoral structured and supervised educational experience approved by the Council on Podiatric Medical Education of the American Podiatric Medical Association which includes residencies and preceptorships. (H) “Amputations” means amputations of the human foot, in whole or in part, that are limited to 10 centimeters proximal to the tibial talar articulation. (I) “Email address of record” means the designated email address recorded by the Department in the applicant’s application file or the licensee’s license file, as maintained by the Department’s licensure maintenance unit. (J) “Address of record” means the designated address recorded by the Department in the applicant’s or licensee’s application file or license file as maintained by the Department’s licensure maintenance unit. Cite to: 225 Ill. Comp. Stat. Ann. 100/5 (2018).

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