APMA Health-Care Solutions: Small Group Enrollment Portal Opens July 1!

June 10, 2021

APMA is delighted to announce that the enrollment portal for its health insurance options for small groups (two or more participants) will open July 1.

APMA has partnered with The Ark Group, a national insurance brokerage with more than 100 years of experience, to provide plans for small groups. While Noveta will continue to support large-group offerings, The Ark Group will provide outstanding service and options for small groups.

APMA deeply appreciates your patience and the patience of its members over the course of the COVID-19 pandemic and other delays as we worked to launch health insurance solutions for small groups. APMA understands these delays may have caused frustration and inconvenience for some members. Rest assured that APMA will follow up directly with those small groups that had already expressed interest in small-group options to ensure they receive the highest level of service and support.

https://www.apma.org/Membership/healthcaresolutions.cfm

Important Information Regarding MIPS Eligible Clinicians Affected by Texas Severe Winter Storm

May 14, 2021

In response to the Federal Emergency Management Agency (FEMA) designation of the Texas Severe Winter Storm as a national disaster, CMS has determined that the automatic extreme and uncontrollable circumstances policy will apply to Merit-based Incentive Payment System (MIPS) eligible clinicians in FEMA-identified Texas areas.MIPS eligible clinicians in these areas will be automatically identified and receive a neutral payment adjustment for the 2023 MIPS payment year. During the data submission period for the 2021 performance period (January 3, 2022 to March 31, 2022), all four performance categories for these clinicians will be weighted at zero percent, resulting in a score equal to the performance threshold.

However, if MIPS eligible clinicians in these areas choose to submit data on two or more performance categories, they will be scored on those categories and receive a 2023 MIPS payment adjustment based on their 2021 MIPS final score.
The automatic extreme and uncontrollable circumstances policy will not apply to MIPS eligible clinicians participating in MIPS as a group, virtual group, or APM Entity.

For More Information

Please reference the Extreme and Uncontrollable Circumstances Overview section on the MIPS > About Exception Applications page and review the fact sheet.

Contact the Quality Payment Program at 1-866-288-8292 or by e-mail at: QPP@cms.hhs.gov. Customers who are hearing impaired can dial 711 to be connected to a TRS Communications Assistant.

DPMs May Administer COVID-19 Vaccine

April 9, 2021

Under President Biden’s direction, the US Department of Health and Human Services (HHS) expanded the class of medical professionals and health-care students who may serve as vaccinators to include licensed doctors of podiatric medicine, recently retired podiatric physicians, and podiatric medical students. Read full article here, https://www.apma.org/News/NewsDetail.cfm?ItemNumber=44262

If you are interested in volunteering to administer the COVID-19 vaccine in Texas you can register with the DSHS here, https://www.texasdisastervolunteerregistry.org/index.php.

In Memoriam – Morris Prigoff, DPM

March 5, 2021

https://www.dignitymemorial.com/obituaries/dallas-tx/morris-prigoff-10089659

Dr. Morris Prigoff passed away on March 4, 2021, after a serious six year illness. He was lovingly cared for at home by his devoted wife Michela, whom he referred to as “my wife for life’”. They were blessed with 19 beautiful years of marriage.

Dr. Prigoff grew up in Syracuse, New York, and was a graduate of the University of Syracuse and the Ohio College of Podiatric Medicine. He was a proud member of the Texas Podiatric Medical Association and a sponsor of the March of Dimes and American Heart Association. A podiatrist of 45 years in Oak Cliff and North Dallas, Dr. Prigoff was loved by his patients for his wonderful care and generous, fun-loving spirit.

At 6 feet, 2 inches tall, Morris had a bigger-than-life personality and a gentle, generous nature. Also known as “Moe”, he gained fame on the show Storage Wars Texas. He loved travelling, teaching, swimming and basketball, gardening, collecting art and his wife’s excellent cooking. He was the owner of River Regency, a mid-century modern furniture and antique store. He had a knack for buying and recreating special pieces and a great love of art and collectibles.

Morris will also be lovingly remembered by his daughter Gina Leonard, son-in-law Paul, grandsons Gavin and Zachary, sisters Rosella Heumann and Suzanne Achleitner, step-son Chase, and many loving nieces and nephews. He will be remembered as well by fans all over the country, and by his many devoted patients.

Funeral arrangements will be completed by Sparkman-Hillcrest in North Dallas. A memorial service will be held later this year as we gather in person to remember and celebrate Morris’ life. In lieu of flowers, contributions in his memory may be made to Congregation Beth Shalom in Arlington Texas.

_______________________________________

Morris Prigoff passed away March 4, 2021. He had practiced in Dallas for 45 years and was loved by his patients.  He was a Past President of TPMA and a Residency Director. He was well known outside of Podiatry from appearing on the television show Storage Wars: Texas. – Chris Bowers, DPM

APMA Advocacy Leads to -59 Modifier Change

January 15, 2021

As a result of APMA’s advocacy efforts, the National Correct Coding Initiative (NCCI) updated Chapter I of the NCCI Policy Manual for Medicare Services in Section E.1.d.(3), Example #2, to reflect a prior determination by CMS specifying that use of Modifier 59 or X[ESPU] is acceptable if the procedures described by CPT® 11720 and 11055 are conducted on lesions that are anatomically separate from one another—even if on the same digit.

Effective January 1, 2021, the NCCI Policy Manual Chapter I now includes an example that reads as follows:

Example 2: The Column One/Column Two code edit with Column One CPT code 11055 (Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion) and Column Two CPT code 11720 (Debridement of nail(s) by any method(s); one to five) should not be reported together for services performed on skin distal to and including the skin overlying the distal interphalangeal joint of the same toe. Modifiers 59 or –X{EPSU} should not be used if a nail is debrided on the same toe on which a hyperkeratotic lesion of the skin on or distal to the distal interphalangeal joint is pared. Modifiers 59 or –XS may be reported with code 11720 if 1 to 5 nails are debrided and a hyperkeratotic lesion is pared on a toe other than 1 with a debrided toenail or the hyperkeratotic lesion is proximal to the skin overlying the distal interphalangeal joint of a toe on which a nail is debrided.

This victory ensures the NCCI Policy Manual language is consistent throughout and accurately reflects CMS policy.

APMA’s 59 Modifier Workgroup was formed last year to address this discrepancy and develop a Routine Foot Care and -59 modifier toolkit. The toolkit includes educational materials and resources to help members when Medicare Advantage plans, Medicaid Managed Care Organizations, or other commercial plans deny covered nail care (CPT® 11720/11721) when callus care (CPT 11055-11057) is provided on the same date.

The workgroup is pleased with this victory and will now work toward the coverage of nail debridement without any restrictions related to callus paring or cutting.

For more information visit www.apma.org/59toolkit.

In Memoriam – Mona Feigenbaum, DPM

January 7, 2021

From the Echovita.com website:

It is with great sadness that we announce the death of Mona Ilene Feigenbaum (Dallas, Texas), who passed away on December 23, 2020, at the age of 62, leaving to mourn family and friends. Family and friends are welcome to leave their condolences on this memorial page and share them with the family.

A graveside service was held on Sunday, December 27th 2020 at the Restland Memorial Park (13005 Greenville Ave, Dallas, TX 75243). 

In Memoriam – Louis Antahades, DPM

December 7, 2020

Louis Michael Antahades, 4/26/32 -11/30/20. Born in Erie, PA where he attended Academy H.S. and Gannon Univ. Matriculated to The Ohio College of Podiatric Medicine graduating in 1956. He served in the U.S. Army stationed at Ft. Chaffee where he established a foot clinic for the service personnel. In 1958, he came to Dallas to establish his podiatry practice. He helped in organizing the Great Southwest Hospital in Grand Prairie where he also served for five years as Chairman of the Board of Trustees. His surgical experience represents well over 30 years. Dr. Antahades has authored papers in the Journal of American Podiatric Med. Assn. and articles relating to the Biomechanics of Skiing. Among his many services he was President of the Dallas County Podiatry Society, Chaired a Legislative group of Antidiscrimination bill that successfully became law in Texas. Too many rewards to mention but one that he was proud off was Humanitarian and Brotherhood of National Conference of Christians and Jews.

Music was always agreat part of his life beginning in H. S. where he played the Saxophone and Clarinet and later in the 90’s formed the Glen Dorsey Band &Orchestra performing for numerous social functions and for 10 years as the main entertainment for the Military Ball. His love of the mountains and outdoors would find him hiking, camping, skiing and serving as an instructor in Idaho for the Natl.

Forest Service. He also found time to teach Sunday School at several Greek Orthodox Churches and later enjoyed Mass with the sisters and parishioners that attended the Holy Family of Nazareth Convent in Grand Prairie. He is survived by his wife, Judyth, daughters Katina, Anastasia and Michaelina Antahades and son-in-law, Eddy Tann and step children, Macie and Lindsey.

His cremated remains will be placed at the memorial in the National Military Cemetery in Dallas.

There will be no funeral but a celebration of life sometime later. May his memory be eternal.

———-

He was a profound leader of TPMA legislative agenda. His close friend was Congressman Chris Semos.

He was a leader and loyal member of TPMA for MANY years.

Major Changes Coming in 2021 for Office/Outpatient E/M Codes

November 19, 2020

Effective January 1, 2021, CMS will be changing the way providers bill for office/outpatient E/M codes. The changes begin with reducing the documentation requirements for the history and exam components, placing the emphasis on the level of medical decision making (MDM) and total time spent in caring for the patient. See below for informational resources.

Texas Podiatric Medicine magazine article

Office / Other Outpatient Evaluation and Management Changes for 2021 training webinar: https://register.gotowebinar.com/recording/720310261709592588

Getting Ready: Documentation for E/M Coding in 2021 training webinar: https://www.apma.org/Events/CalendarEventDetail.cfm?EventID=121159

Overview of the changes: https://www.apma.org/em2021

APMA will do another webinar on December 17, 2020, to show examples on how the new E/M rules should be applied. More information on this webinar will be coming soon.

Step Into Podiatry

October 19, 2020

We are asking all podiatrists to help to promote podiatry to the next generation.

To help facilitate this process, APMA has created a webpage, Step Into Podiatry, that provides excellent resources for high school and undergraduate students. Included on the website are flyers, videos and a customizable PowerPoint presentation for prospective students, which can be used when speaking with student groups or individuals.

In Memoriam – Gilmore E. Guster, DPM

September 17, 2020

It is with a heavy heart and great sadness hearing of the passing of Dr. Gil Guster on September 12, 2020, my peer, my mentor, and especially one of my dearest friends. Gil was one of our unsung leaders of podiatry in the Houston and Clear Lake, NASA community during the ’70s through the ’90s. He never said no to helping or guiding any new podiatrist moving into the area.

He was held in great respect not only by his fellow podiatrists but also with the MD community. He will be missed by many but never forgotten. My condolences to his wife Evie who lives in the San Diego area where they have resided together for the past several years. He is also survived by his two adult children and their families.

RIP Gil.

Michael A Mineo, DPM
Galveston, TX