Coding & Reimbursement Committee

MISSION STATEMENT: Providing accurate and timely coding information to AOPA members and other interested parties.

CHARGE: The Coding & Reimbursement Committee (CRC) analyzes and researches issues relating to the appropriate coding for O&P devices. The Committee develops the Association’s opinions and recommendations on appropriate coding. The Committee communicates this information to the membership and to other interested parties through regular communications, seminars, and special notices.  The Committee may establish “work groups” as necessary to ensure accomplishment of its annual objectives and to enhance membership involvement.  Work groups may be composed entirely of CRC members, but each work group must have at least one member of the CRC.

Specific roles:

  • Research and respond to member’s direct inquiries regarding appropriate coding;
  • Develop the Association’s recommendations on coding particular O&P items;
  • Provide coding and general O&P clinical information to the Durable Medical Equipment Regional Medicare Administrative Contractors, other allied health professionals, the Centers for Medicare and Medicaid Services, and other government agencies or claims processing intermediaries;
  • Keep up to date with specific issues relating to policies on coding and reimbursement for O&P;
  • Conduct training seminars for the membership and other interested parties on all aspects of O&P coding on an as needed basis; and serve as the central point of contact and position itself as the sole source for information on accurate O&P coding.

COMPOSITION: 8-10 members, appointed by the President.  In making committee appointments, the President should seek to introduce new participants each year, and limit tenure to 2 years.

VALUES AND EXPECTATIONS:

  • Committee members should be certified practitioners.
  • There should be broad geographic representation among members (suggest at least one representative from each of the four DME MAC regions).
  • Committee members should have significant clinical experience as well as be well versed in current Medicare/CMS/DME MAC coding and reimbursement requirements.
  • Committee members must be committed to supporting the decisions, opinions, and recommendations of the committee, regardless of their personal views or individual facility practices.
  • When speaking on behalf of the committee (or when perceived to be representing AOPA or the Coding Committee), members must unconditionally support, and be advocates for the committee’s conservative view of coding within all applicable laws, rules, regulations, and practices.
  • Committee members must be dedicated to the work of AOPA and the CRC and willing to commit to volunteering significant time and serious attention to the committee’s mission and goals.

Members must be team oriented and respect and value the views and opinions of others in order to provide consistent and appropriate coding recommendations and information to the membership for the overall advancement of O&P.  This committee meets monthly.

To apply to serve on a specific committee, please complete the online application at https://aopa.wufoo.com/forms/aopa-call-for-volunteers/

For a list of current volunteers serving on this committee, click here.

AOPA staff liaison for this committee: Devon Bernard dbernard@AOPAnet.org and Joe McTernan jmcternan@AOPAnet.org.