08/12/2025    Paul Kesselman, DPM

RE: WISeR (Wasteful and Inappropriate Service Reduction) Model (Joseph Borreggine, DPM)

Let me make some corrections to my friend and
colleague Joseph Borregine's comments on the WISer
program. This is a Voluntary program which is
available in only six states New Jersey, Ohio,
Oklahoma, Texas, Arizona and Washington.
It is open to any provider. practitioner,
including DPMs who provides a subset of specific
procedures It is based on and does not usurp
specific LCDs which have jurisdiction over those
procedures. It is not biased for or against any
specialist.

Dr. Borreggine specifically stated that
dermatologists were exempt from this program. That
is false! Rather, it should have stated that post
Moh's surgery grafting is not subject to the WISeR
program. The reason is because MOHS surgery is NOT
listed as part of the LCD covering skin
substitutes of the Lower Extremity.

The LCD for skin Ssbstitutes specifically only
addresses their use on diabetic or venous wounds.
That LCD also does not address the use of Skin
Substitutes on the arm, hand, face or other body
part other than the lower extremities. That LCD
also does not address the use of Skin Substitutes
on the lower extremity or any other body part due
to acute traumatic wounds or due to radiation,
burns, trauma, etc. If on the foot or lower leg,
these too could be treated by a DPM but would not
be subject to the voluntary WISeR program nor the
LCD.

As for what APMA is doing about it, that is for
them to answer. In my opinion, this is a voluntary
program and only the best providers who have a
chance at gaining a bonus will bother to sign up
for it. Will it be expanded:? Will P/A for CTP
become mandatory? This will play itself out as
more DME and CPT procedures are abused and P/A
programs show themselves to be effective at
cutting costs! Only time will tell.

But the WISeR program definitely DOES NOT
discriminate against DPMs.

For more information on the WISeR program, Please
Click on http://podiatrym.com/go.cfm?n=14795

Paul Kesselman DPM, Oceanside, NY

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