WISeR Program Not So Wise
A recent Newsweek column left me chuckling. Apparently the WISeR program is not so wise! The use of AI by the WISeR program to issue prior authorization is a test pilot program in six states (only four affect podiatrists). Apparently the use of their AI programs is creating havoc and significant delays in patient care have resulted. Perhaps the House Appropriations Committee would be WISER and discontinue funding of this program, at least until the vendors WISE UP!
—Paul Kesselman, DPM
Trigger Point Injections
Question: For trigger point injections, is there a new Medicare policy LCD and billing? I was informed that Novitas Medicare posted on their website, dated 9.8.26, a new LCD and billing article for trigger point injections. Can you provide some information?
Response from Codinghelpline.com:
Notice: September 8, 2026, TPI (Trigger Point Injection)—The following LCD and related billing and coding article are now effective for dates of service on and after 9.6.26. More information here.
TPI Medical Necessity Checklist
☐ Specific painful muscle-region identified
☐ Palpable trigger point documented (firm and/or hypersensitive nodule in taut muscle band identifying the name of the muscle).
☐ Objective exam findings documented (e.g., local twitch or referred pain, if present should be a minimum documented).
☐ Diagnosis supports myofascial trigger-point pain (e.g., M79.18 – Myalgia, other site, when clinically appropriate.).
☐ Patient participating in a multimodal pain-management program (e.g., means the patient is using more than one type of treatment strategy to manage their pain—not relying on trigger-point injections alone. Examples can include: Exercise and/or physical therapy — stretching, strengthening, mobility, home exercise program; Medications — when appropriate; Behavioral approaches — pain coping strategies, relaxation techniques; Self-management — activity modification, home exercises, education; Other noninvasive treatments — depending on the patient's condition.
☐ Reason for TPI documented.
☐ Response to prior TPI documented, including duration and the degree of relief.
☐ Number of TPI sessions in prior 12 months documented.
☐ If 4th session: exceptional circumstances and required attestation documented.
Key audit point: The physical exam must demonstrate the trigger point. The diagnosis code alone isn't sufficient in an audit. The provider needs to document the corresponding palpable trigger point in the muscle and the required physical-exam findings. The LCD specifically excludes TPI for fibromyalgia, low-back pain, or other conditions when trigger points aren't demonstrated.
—David J Freedman, DPM, CPC, CSFAC, CPMA
Additional coding and billing questions and responses can be found at www.Codinghelpline.com
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Preview: September ‘26 Podiatry Management
Dividend-Paying Stocks
You know how hard you work for your money and how difficult it is to save after paying monthly living expenses and taxes. You need to have your money work for you. At some point, you should have saved an amount great enough to produce an income stream that would enable you to “slow down,” or even retire. While you are still working full time, you should be striving to achieve savings that will generate an income stream that can be used to meet unexpected personal expenses while also serving as investment for the future.
MGMA Adds Its Voice to Modifier 25 Opposition
Medicare's 2027 pay proposal would pay a practice in full for one service and 50 percent for the other when an office visit and a procedure happen on the same day. MGMA spent the closing hours of the Sept. 14 comment window trying to kill it.
Source: Physicians Practice
When will the emergence of new technologies (AI and others) affect your staffing plans?
Recognizing Your Employees
Although you may think you’ve been expressing the appropriate amount and type of appreciation for your staff, they may not be so impressed.
Source: Medical Economics
U of Michigan Podiatry Fellowship
Interested parties should complete and provide the information requested in the Podiatry Fellowship Training Program Application. Your application will not be processed or considered unless all information requested is received. Please refer to the application for how to submit once complete.
Application Deadline for 2027-28: 10.1.26 | Start Date: 7.7.27
Source: U of Michigan
Disconnect Between HC Staff, Employers
Although 59 percent of U.S. health care workers say they are likely to look for job openings, interview for, or switch to a new role in the next year, according to the 2026 Healthcare Workforce Barometer, employers surveyed alongside them estimated that only 39 percent of their own staff would.
Source: Physicians Practice
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Unpacking the Toe Spacer Trend
DPMs may be seeing a recent increase in patients asking about or using minimalist shoes and toe spacers. Dana Figura, DPM, digs into this and offers some cautionary advice for physicians and patients alike.
Source: Yahoo Creators
Webinar: Lower Extremity Applications of Orthobiological Products
This educational webinar by Kurt Massey, DPM, will provide participants with an evidence-based overview of orthobiological products and their applications in lower extremity surgery.
The presentation will review the characteristics and properties of commonly used orthobiological products, as well as their proposed mechanisms of action and potential role in promoting tissue healing. The presentation will also review current scientific literature regarding the use of orthobiologics in lower extremity procedures and highlight specific surgical applications where these products are utilized.
Thursday, 10.29, noon Eastern
Source: Present Podiatry
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Most Physicians Now Work for Large HC Systems or Hospitals—But Not DPMs
Physicians in the U.S. are increasingly employed by hospitals and other corporate entities. Across the 700,000 physicians assessed by a Trilliant Health analysis, 59.4 percent are employed by a hospital or health system. The share of hospital-employed physicians varies by region. The share of hospital-employed physicians also varies by specialty, from 78.8 percent in hematology and oncology to 26.9 percent in podiatry.
Source: Repertoire Magazine
PM Pulse Classified Ads
Full-Time Chair—Department of Podiatric Medicine & Surgery
The Dr. William M. Scholl College of Podiatric Medicine is seeking a full-time chair for the Department of Podiatric Medicine & Surgery. The chair will lead faculty, drive academic excellence, and oversee clinical experiences in a collaborative environment. Generous benefits! ($120K–$140K)
Contact:[email protected] or apply at https://www.rosalindfranklin.edu/employment/
Associate Wanted
Practice seeks associate in Connecticut. Owner will stay for transition. Full privileges available. Fax resume to 203-729-9046.
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