APMA News - September 2012 - (Page 27)

Reimbursement a DME audit and you, as the supplier, have been incorrectly coding the device you dispense, you, not the manufacturer or its representatives, will be held accountable for the claim(s). within your patient supplier records. As the supplier, you will also need to have completed and signed a “statement of certiﬁcation” from the certifying physician for the diabetic shoes/inserts, as well as a copy of the certifying physician’s recent medical record showing a diabetic treatment plan is actively being followed by the physician treating the patient’s diabetes. By having these three items in your supplier records, you should be reasonably protected in case of audit. If you are audited and believe you have done (and recorded) everything expected of you, the committee recommends that you take advantage of the appeal process, even if that includes taking the denial defense up to and including an Administrative Law Judge hearing level for ﬁnal resolution. In addition to these topics, the committee spent a signiﬁcant amount of time reviewing ICD-10-CM updates, crosswalks, and scenarios. Look for coverage of those subjects in a future installment of the Reimbursement column. ■ DME Issue: Diabetic Therapeutic Shoes and Insoles A number of APMA members have reported over the past year that DME Medicare carriers have been aggressively carrying out both pre- and post-payment audits on diabetic therapeutic shoes and insoles. The committee strongly recommends, until CMS modiﬁes its stance, that podiatrists who function as prescribing physicians and suppliers send two copies of their medical record to the attending physician (i.e., certifying physician) treating a patient’s diabetes. Both copies should include a section at the end for the certifying physician to complete attesting to the lower extremity ﬁndings included in the podiatrist’s medical record, as well as agreeing there is a medical necessity for diabetic shoes and inserts for the patient. One signed copy is for the certifying physician’s patient record, while the other signed copy is returned to you, the supplier, for inclusion Contact Dr. Kinberg at coding.hpp@apma.org. JULY 21-25, 2013 LAS VEGAS, NEVADA THE VENETIAN THE PALAZZO CONGRESS CENTER AND SANDS EXPO July 21-24, 2013 • Las Vegas, Nevada The Venetian The Venetian and Palazzo Resort, Hotel and Casinos rank number 5 on Cvents Top Ten Meeting Hotels list. The Palazzo Congress Center and Sands Expo www.apma.org/thenational APMA News September 2012 27 http://www.apma.org/thenational http://www.apma.org/thenational

Table of Contents for the Digital Edition of APMA News - September 2012

APMA News - September 2012
President’s Message
Contents
US Surgeon General Addresses APMA at The National
2012 is a Milestone Year for APMA, and for Other Institutions as Well
APMA Member and Daughter Help Disabled Find their Freedom
Dr. Caporusso Promotes Podiatric Medicine on Capitol Hill
Use eAdvocacy to Reach Your Elected Leaders Today!
APMA by the Decade: 1982–1991
2012 Podiatric Practice Survey: Net Income Statistics
Reimbursement
Federal Advocacy Forum
List of Cosponsors to the Equity and Access for Podiatric Physicians Under Medicaid Act
APMAPAC Chair Report
IT Consultant
Website Wisdom
Technofile
Bylaws Propositions Due
Small Business 101
APMA All Stars
Resolutions Deadlines
In Short
Worthy of Note
CPME Invitation for Comments
Affiliates Corner
List of Affiliated Organizations
Insurance Advisor
New Members
Death Notices
APMAPAC Update
Annual Scientific Meeting Sponsors
Development Update
Classified Advertising
Dates to Remember
Advertising Index
10 Questions
Your APMA

APMA News - September 2012