Medicare Provider Advantage Issue

A Medicare Advantage issue (below) has recently been brought to us from Tennessee. We would like to know if this issue was occurring in your state, and if so, whether or not you been able to resolve it or work with the Medicare Advantage plan to loosen their prior authorization requirements.
 
Here is the issue:
 
WINDSOR/WELLCARE is a Medicare Advantage plan and they state as of August 1st, 2017, they added several codes to their prior-authorization list.  The ones that are directly affecting podiatry practices are: 11055, 11056, 11057, 11720, 11721 (all nail care codes), all of the ulcer debridement codes; 11042, 11043, 11044, 11045, 11046, 11047, excision of benign lesions 11400-11406 and 11420-11426, application of a graft 15275, wart removal 17110 and a couple of injection codes:  20600 and 20605.
Please send Dr. Jamelah Lemon any feedback you may have so that she can report it back to APMA.  Her contact information is below.


Jamelah Lemon, DPM

Email: jlemon16@gmail.com
Office Phone: (843)553-2235
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