A Medicare Billing Breakdown Is Putting Limb-Saving Care at Risk Across 24 States

Описание: A Medicare billing issue affecting 24 states could soon limit access to limb-saving care for patients with Peripheral Artery Disease (PAD)—a disease more deadly in advanced stages than many common cancers.

On this episode of The Heart of Innovation, host Kymberlie McNicholas is joined by guest co-host Dr. Todd Berland, vascular surgeon and host of The Vascular Surgery Show on SiriusXM Doctor Radio.

They are joined by:
🔹 Dr. Elliot Adams – directly impacted by Medicare denials in his office-based lab
🔹 Dr. Bob Tahara – past president of OEIS, working to clarify and resolve the issue with Medicare

Physicians report that new CPT codes for PAD revascularization procedures, which went into effect January 1, are being denied by Medicare contractors Noridian and Novitas when performed in office-based labs—despite being billed correctly. Some practices report they have not been paid since January 1, raising concerns about sustainability and patient access.

In this episode, we discuss:
• Why office-based labs are essential to limb salvage
• How reimbursement delays can force doctors to cut back procedures
• Why PAD patients cannot afford delays
• What happens when care is denied or postponed
• How this compares to ongoing delays under Medicare Advantage plans

🚨 If you are a physician, clinician, or billing professional seeing these denials, we want to hear from you.
🚨 If you are a patient who has received a Medicare denial or delay for PAD care, your story matters.

📞 Leg Saver Hotline: 1-833-PAD-LEGS
🌐 Patient education & support: www.PADhelp.org

🎧 More episodes: www.TheHeartofInnovation.org

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