US-POLITICS: NAAOP ACTION ALERT
Description
Collection
Title:
US-POLITICS: NAAOP ACTION ALERT
Text:
CMS will not address HIPAA coding issue
For the past year and a half, the National Association for the Advancement of
Orthotics and Prosthetics (NAAOP) has been working with a number of DMEPOS
interest groups to limit the negative impact that phasing out local Medicaid
billing codes will have on DMEPOS, particularly O&P.
Beginning October 2003, all Medicaid and private insurance claims must use
HCPCS codes. No local, Level III codes will be permitted. Procedures and
devices that are currently billed under local codes and are not consistent
with national Level II codes will have to be billed differently after
October.
Unless replacement Level II codes are established, current local codes will
disappear and you must either contend with the not-otherwise-classified
codes or reduce the level/intensity of patient care. Regardless, there will
be an immediate impact on States who have established specific local codes
which address the inadequacies of HCPCS, including the Pediatric population.
Throughout the many meetings and phone calls with CMS, our coalition believed
it was making progress in getting CMS to realize the huge problem created
next fall if something is not done. Unfortunately, yesterday, we learned
that our hopes will not be realized.
The CMS staff with whom we have been working, including Medicaid staff, have
actually stated there really is no problem! They expect, as long as new
L-code applications are submitted by the April 1, 2003 deadline, whatever new
codes need to be created could become effective January 1, 2004.
This presumes that O&P will take the issue on directly, without the help or
coordination of CMS and State Medicaid programs. State O&P organizations are
now tasked with compiling a list of new codes that will be needed, completing
multiple coding applications (perhaps hundreds), and submiting them to CMS by
COB Tuesday, April 1, 2003.
Further, we understand that some of the state Medicaid programs may be
submitting new coding applications for a few local DMEPOS items and
services. However, review of the preliminary crosswalked data indicated
numerous errors had occurred. Oversight in these instances will help prevent
improper crosswalking of codes.
Several State O&P Organizations began the process of identifying applicable
local codes when NAAOP brought this issue to light last year. It is now time
(and that time is very, very short) for the States who will be affected to
combine their resources and tackle the task. I encourage all practitioners
who use Level III codes to describe O&P services to contact their State
Academy Chapter and/or O&P Organization to see what actions can or are being
taken to address this problem.
As you can tell, this issue will require a substantial effort for some
States.
For more information, please see;
HCPCS Code Modification Process
RE: The 2004 HCPCS Update
<A HREF= <URL Redacted>> <URL Redacted></A>
NAAOP stands ready to assist.
Mike
Michael J. Allen, CPO, FAAOP
President
<A HREF= <URL Redacted>>National Association for the Advancement of Orthotics & Prosthetics</A>
1875 Eye Street, N.W., 12th Floor
Washington, D.C. 20006-5409
Phone: 202-624-0064
Toll-Free: 800-622-6740
Fax: 202-737-2517
Internet: http://www.oandp.com/naaop
Personal contact information,
Allen Orthotics and Prosthetics
2502 West Ohio
Midland, Texas 79701-5848
Phone - 915/683-3788
Fax - 915/683-6470
E-Mail - <Email Address Redacted>
For the past year and a half, the National Association for the Advancement of
Orthotics and Prosthetics (NAAOP) has been working with a number of DMEPOS
interest groups to limit the negative impact that phasing out local Medicaid
billing codes will have on DMEPOS, particularly O&P.
Beginning October 2003, all Medicaid and private insurance claims must use
HCPCS codes. No local, Level III codes will be permitted. Procedures and
devices that are currently billed under local codes and are not consistent
with national Level II codes will have to be billed differently after
October.
Unless replacement Level II codes are established, current local codes will
disappear and you must either contend with the not-otherwise-classified
codes or reduce the level/intensity of patient care. Regardless, there will
be an immediate impact on States who have established specific local codes
which address the inadequacies of HCPCS, including the Pediatric population.
Throughout the many meetings and phone calls with CMS, our coalition believed
it was making progress in getting CMS to realize the huge problem created
next fall if something is not done. Unfortunately, yesterday, we learned
that our hopes will not be realized.
The CMS staff with whom we have been working, including Medicaid staff, have
actually stated there really is no problem! They expect, as long as new
L-code applications are submitted by the April 1, 2003 deadline, whatever new
codes need to be created could become effective January 1, 2004.
This presumes that O&P will take the issue on directly, without the help or
coordination of CMS and State Medicaid programs. State O&P organizations are
now tasked with compiling a list of new codes that will be needed, completing
multiple coding applications (perhaps hundreds), and submiting them to CMS by
COB Tuesday, April 1, 2003.
Further, we understand that some of the state Medicaid programs may be
submitting new coding applications for a few local DMEPOS items and
services. However, review of the preliminary crosswalked data indicated
numerous errors had occurred. Oversight in these instances will help prevent
improper crosswalking of codes.
Several State O&P Organizations began the process of identifying applicable
local codes when NAAOP brought this issue to light last year. It is now time
(and that time is very, very short) for the States who will be affected to
combine their resources and tackle the task. I encourage all practitioners
who use Level III codes to describe O&P services to contact their State
Academy Chapter and/or O&P Organization to see what actions can or are being
taken to address this problem.
As you can tell, this issue will require a substantial effort for some
States.
For more information, please see;
HCPCS Code Modification Process
RE: The 2004 HCPCS Update
<A HREF= <URL Redacted>> <URL Redacted></A>
NAAOP stands ready to assist.
Mike
Michael J. Allen, CPO, FAAOP
President
<A HREF= <URL Redacted>>National Association for the Advancement of Orthotics & Prosthetics</A>
1875 Eye Street, N.W., 12th Floor
Washington, D.C. 20006-5409
Phone: 202-624-0064
Toll-Free: 800-622-6740
Fax: 202-737-2517
Internet: http://www.oandp.com/naaop
Personal contact information,
Allen Orthotics and Prosthetics
2502 West Ohio
Midland, Texas 79701-5848
Phone - 915/683-3788
Fax - 915/683-6470
E-Mail - <Email Address Redacted>
Citation
“US-POLITICS: NAAOP ACTION ALERT,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/220728.
