Medicare Advisory Liaison

19th Annual Joint National Podiatric CAC-PIAC Representatives’ Meeting I recently attended the 19th Annual Joint National Podiatric Carrier Advisory Committee (CAC)-Private Insurance Advisory Committee (PIAC) Representatives meeting, held in Alexandria, VA, November 15, 2019, on behalf of the IPMA This annual meeting presents a unique opportunity for CAC and PIAC representatives to hear from experts […]

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Medicare Advisory Liaison

NGS Medicare Update New Conversion factor : January 1, 2020 – $36.09 RVU= physician work, practice expense (rent, equip, supplies), malpractice GPCI= geographic differences (established for each RVU Conversion factor= CF converts RVUs into actual dollar amounts Fee Schedule to be posted on NGS website soon Evaluation and Management Update What parts of the history […]

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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 […]

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Medicare Advisory Liaison

Modifier 59 – Distinct Procedural Service Modifier 59 is defined as a “distinct procedural service.” Under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non E&M services performed on the same day. Modifier 59 is used to identify procedures or services, other than E&M […]

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Medicare Advisory Liaison

New Medicare Data Results The Part B Medicare data from 2017 has just been released. The complete data can be found at the APMA website. I will share some of the highlights of the data. As a reminder the data is always one year behind so 2018 data will not be available until next year. […]

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Medicare Advisory Liaison

Routine Foot Care 101 The most common codes billed and most commonly misunderstood codes are those dealing with routine foot care. Below are the guidelines from NGS for coverage with examples of coding scenarios.  Please note for Group 1 and 4 codes you only need one diagnosis code. I never use the callus diagnosis or […]

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Medicare Advisory Liaison

NGS Connex Issues Connex and web based issues email: ngswebsupport@anthem.com. When contacting NGS on Connex issues add a brief synopsis of what they are experiencing. The web support team will then reach them via their preferred method of communication. CMS Takes Action to Modernize Medicare Home Health On July 2, CMS proposed significant changes to the Home […]

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