APMA News - July/August 2020 - 27

APMA Committee Work
Continues Virtually

S

ince March, everyone has had to find and accept new
ways of doing things due to the COVID-19 public
health crisis. APMA's volunteer-led committees are no
different. Ensuring their important work continues
unimpeded, the Health Policy and Practice Committee
(HPPC) and Coding Committee met in early June to discuss
and address numerous topics that affect you and your patients every day.
HPPC met on Friday, June 5. The committee, chaired by John
Evans, DPM, discussed the numerous efforts surrounding
member education and advocacy related to COVID-19, including telehealth changes, small business resources like the Paycheck Protection Program, and the Medicare Provider Relief
Fund. The group also discussed current reimbursement trends
and policies, covering both public and private insurance plans.
Specific subjects covered included the upcoming 2021 changes
to E/M coding policies, changes to private insurance -25 modifier policies, and DME topics including recent laterality denials
and the continued issues with "same or similar" policies.
The group talked extensively about ongoing concerns surrounding the -59 modifier and the issues of some Medicare
Advantage Plans and Medicaid managed care plans denying
covered nail care (CPT 11720/11721) when callus care (CP
11055-11057) is provided on the same date. Just a few days
after the meeting, APMA submitted a letter to CMS expressing concerns that the National Correct Coding Initiative Policy Manual for Medicare is inconsistent and needs to be updated to accurately reflect CMS policy. The letter is available
at www.apma.org/commentletters. The committee also
formed a working group to create member-education materials about this topic.
The committee laid out its member education plan and advocacy priorities for the year, as well as making plans for
cross-collaboration with other committees, and additional

outreach to other industry stakeholders to collaborate on
shared advocacy concerns. The committee formed a working
group specifically to address -25 modifier education and to
address private insurance policies that reduce reimbursement
when a provider performs a separately identifiable E/M and a
procedure on the same day.
The Coding Committee met the following day, June 6.
Committee Chair David Freedman, DPM, led the committee
through a comprehensive discussion on coding policy updates. Updates included COVID-19-related coding changes,
proposed changes to HCPCS L3000, upcoming 2021 changes to E/M coding, and opportunities for member education
via articles, webinars, podcasts, and infographics.
During the coming year, the committee plans to focus its
educational efforts on coding hot topics such as documentation, E/M, modifiers, and more. Keep an eye on your APMA
publications and www.apma.org/coding for more information about these topics, particularly the E/M changes.
The day before the HPPC meeting, APMA held its annual
DME Stakeholder meeting virtually. Participants in the meeting included representatives from APMA, AAOS, AOFAS,
AOTA, PFA, AOPA, APTA, and AOA. The stakeholder groups
discussed proposed changes to HCPCS L3000, laterality denials, and continued advocacy related to "same or similar,"
and all groups agreed to collaborate further throughout the
year. Paul Kesselman, DPM, shared relevant information from
this meeting with HPPC and Coding Committee attendees on
Friday and Saturday.
APMA members can find a wealth of information about
reimbursement and coding on APMA.org, including webinars, videos, podcasts, and more. Take some time to explore
the website and make the most of your membership. If you
need additional assistance, contact healthpolicy.hpp@
apma.org. n
APMA News July/August 2020

27
http://www.apma.org/coding http://www.apma.org/commentletters http://www.APMA.org
APMA News - July/August 2020

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