Podiatrists treat a very specialized set of symptoms, diseases, and conditions related to the foot and ankle. These specialists address a range of medical areas, including sports medicine, wound care, diabetic care and surgeries, which keeps them very busy. Podiatry coding and billing is complex as procedures and services related to the foot are very specific because of medical necessity requirements and restrictions on the conditions that can be treated. To maximize their reimbursement, these specialists need to understand what will be covered, choose the appropriate codes for their services, and ensure clean documentation.

Experienced podiatry billing companies will handle all tasks related to claims processing including reviewing claims to ensure proper coding, verifying eligibility benefits, sending out claims, and keeping track of all accounts receivable. They also file claims electronically.

Medicare coverage for podiatry services

In podiatry services, CMS will provide coverage only for treatments that are considered medically necessary and reasonable foot care. Treatments that get coverage are often related to bunion deformities and heel spurs. Medicare also covers a foot exam every six months for patients with diabetes, diabetic peripheral neuropathy and loss of protective sensations.

Based on CMS’ fact sheet, it will not cover certain foot care services such as routine foot care, flat foot, subluxation of the foot, supportive devices of the foot and therapeutic shoes for individuals with diabetes, unless and until it is an emergency. In the case of ‘routine foot care,’ coverage will be provided in certain circumstances such as – if the patient is suffering from a disease affecting circulatory problems or lack of sensation in the legs/ feet, warts, infections, ulcers, wounds and needs treatment, fungal treatment, and the presence of a metabolic, neurologic or peripheral vascular disease. Routine foot care includes the treatment of corns and calluses (cut and removal), nail treatment (cut, clip, and debridement), hygiene care or other services not indicating any infirmity or injury.

1. Proper insurance verification

Health insurance verification is all about the process of checking a patient’s active coverage with the insurance company and verifying the eligibility of his or her insurance claims. Insurance verification is the initial process in podiatry billing. Checking and verifying the patient’s insurance eligibility and benefits prior to the treatment helps reduce denial rates and increase cash flow. Patients must be informed of their payment responsibilities at the time of appointment scheduling, which helps them decide on the course of treatment and the practice can also avoid last minute cancellations due to ineligibility reasons.

Along with checking the patient’s insurance coverage with the concerned insurance company, make sure to verify all details including patient’s name, date of birth, address, insurance ID number, deductible and insurance phone number.

2. Accurate codes matter

Podiatry coding also involves challenges. The most appropriate code available should be used to document podiatry procedures in medical claims. For all medical claims, whether related to pressure ulcers, infections, injuries, active wound care management or debridement, it is critical to include the right CPT, HCPCS and ICD-10 codes.

Medical codes used in the billing of foot care are:

CPT

  • 11055 – Trimming of skin lesion
  • 11056 – Trimming of skin lesion (two to four)
  • 11057 – Trimming of skin lesion (more than four)
  • 11719 – Non-dystrophic nails trim
  • 11720 – Debridement of nail (till 5)
  • 11721 – Debridement (more than six)
  • 11730 – Partial or complete nail plate avulsion
  • 11732 – Additional partial or complete nail plate avulsion

HCPCS

  • G0127 – Trimming of dystrophic nails, any number
  • G0245 – Initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) which must include: (1) the diagnosis of lops, (2) a patient history, (3) a physical examination that consists of at least the following elements: (a) visual inspection of the forefoot, hind foot, and toe web spaces, (b)evaluation of a protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear and (4) patient education

ICD-10

  • B35.3 – Tineapedis
  • B07.0 – Plantar wart
  • E11.621 – Type 2 diabetes mellitus with foot ulcer
  • E13.4 – Other specified diabetes mellitus with neurological complications
  • S83.9 – Sprain of unspecified site of knee
  • S93.3 – Subluxation and dislocation of foot

Coders should stay updated with the changing coding standards and guidelines, as any errors in codes submitted can result in denial of claims or delayed payment.

3. Choose the right modifier

In a claim form that includes certain procedure codes, it will be required to add suitable modifiers to differentiate between the codes that were charged on the date of service. In podiatry, “Q” Modifiers (Q7, Q8, and Q9) are utilized to denote Class A (Q7), Class B (Q8) and Class C (Q9) findings.

Key modifiers used in podiatry billing are –

  • GX Notice of liability issued, voluntary under payer policy
  • GZ Item or service expected to be denied as not reasonable and necessary
  • Q7 One Class A finding
  • Q8 Two Class B findings
  • Q9 One class B and 2 class C findings

“Q” modifiers may be used with procedure codes 11055, 11056, 11057, 11719, 11720, 11721 or G0127. Submitting claims using Q7, Q8, or Q9 modifiers indicates the findings related to the patient’s condition.

  • Class A Findings: Non-traumatic amputation of the foot or integral skeletal portion thereof.
  • Class B Findings: Absent posterior tibial pulse, advanced trophic changes and absent dorsalis pedis pulse.
  • Class C Findings: Claudication, temperature changes, edema, paresthesias and burning.

Usage of precise modifiers also helps to boost collections, minimize errors and avoid dwindling revenues.

4. Claims Involving Complicating Conditions

For podiatry claims involving complicated conditions, coders must

  • document the name of the physician who diagnosed the condition on the first submission of the claim along with the approximate date that the beneficiary was last seen by the indicated physician (when active care is required)
  • carefully document the severity of the diagnosis, not just the diagnosis itself

5. Appeal for denials

A claim may be denied, when the insurer has decided not to cover a claim and the claim will not be paid. Before appealing the claim, check the explanation of benefits (EOB) sent by the health insurance company to know the exact reason for denial. When appealing, the reason for denial should be addressed. Certain information may be missing and arguing medical necessity would not be of any value because that is not the basis for the denial. Also, check the carrier’s written policy to know the exceptions. After submitting the appeal, the practice staff should also call and confirm that the insurance company has received the appeal, or review the submission online and then follow it up in 30 days.

Coders and billing staff should also keep pace with regulatory updates to provide accurate documentation. When choosing an outsourced podiatry billing firm for such documentation tasks, make sure they are specialized in podiatry and have a proven track record in the medical billing industry.

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  162. Oh my goodness! Amazing article dude! Many thanks, However I am experiencing problems with your RSS. I don’t understand the reason why I can’t subscribe to it. Is there anyone else having similar RSS problems? Anyone that knows the answer can you kindly respond? Thanx!

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  174. พวกเรา UFABET แจกให้คุณได้มากที่สุด พร้อมโปรโมชั่นส่วนลดมากมายก่ายกอง ถ้าคุณเป็นคอหวยก็ไม่ควรพลาดเด็ดขาด หรือถ้าคุณเป็นผู้ที่ติดอกติดใจ แทงมวย มองมวย เราก็มี มวยไทย ให้ท่านได้เลือกเล่นเลือกแทง สดสดจากเวทีดังทั่วประเทศ แค่เพียงคุณนั่งพักผ่อนที่โทรศัพท์มือถือของคุณก็สามารถเลือกแทงมวย ได้ทั่วประเทศ รวมทั้งนี่คือบริการที่พวกเราจะให้ท่านทั้งปวงนี้สำหรับ
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  176. ถ่ายทอดสดผ่านเว็บไซต์
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  177. เสือมังกร หรือ Dragon Tiger เป็นเกมที่พบได้บ่อยในคาสิโนในแถบทวีปเอเชีย ซึ่งเป็นเครื่องหมายแทนการต่อสู้ระหว่างสัตว์ที่ทรงพลังสองจำพวกในตำนานจีน
    เป็นเกมซึ่งสังกัดโชคล้วนๆมีการเล่นที่ง่ายและเร็ว โดยวางเดิมพันจากตัวเลือกเพียงแค่ 3 ตัวเลือกเป็นมังกร (Dragon), เสือ (Tiger) แล้วก็เสมอเพิ่มบล็อก

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  180. สำหรับผู้ใดที่เลือก
    จะวางเดิมพัน กับเว็บไซต์พนันบอล
    อย่าง UFABET พนันบอลออนไลน์ ด้วยการเล่นบอลสด หรือใช้บริการกับเว็บแทงบอลสด แทงบอลUFABET นี้ ถือว่าพวกเรา สามารถที่จะสร้างกำไรให้เกิดขึ้น หรือสร้างความได้เปรียบให้เกิดขึ้น กับตนเองได้เพราะแน่นอนว่า หากเราต้องการที่จะได้กำไร จาก เว็บไซต์แทงบอล หรือได้เงินพนัน จากการวางเดิมพันในคู่บอล ที่เลือกวางเดิมพัน ลงไปการ เข้าไปดูบอลสด ถึงแบบอย่างการบุก การรุก การรับ มันจะช่วย
    เพิ่มช่องทาง ของพวกเราได้มากขึ้น

  181. การสมัครสมาชิกกับทางเว็บของพวกเราก็สามารถทำได้ง่ายๆเพียงไม่กี่ขั้นตอน
    ไม่ว่าจะเป็นการสมัครผ่านระบบอัตโนมัติหรือจะผ่านทางคอลเซ็นเตอร์ก็สามารถทำได้ทุกวิถีทาง ลงทะเบียนสมัครสมาชิกไม่มีอย่างต่ำ ท่านก็เลยสามารถทดสอบสมัครเข้ามาเล่นกับเว็บพวกเราได้ตลอดระยะเวลา
    ซึ่งจะมีเจ้าหน้าที่ผู้ชำนาญรอให้คำแนะนำและก็อำนวยความสะดวกให้แก่ท่านตลอดเวลา ถ้าว่าท่านอยาก

  182. ราคาของกีฬาบอลราคาน้ำ 4 ตังค์
    คืนค่าคอมมิชชั่นลงไปในเกมส์ 0.5%
    ทุกใบเสร็จรับเงินการเล่น ราคาเยี่ยมที่สุดกว่าทุกเว็บฯ
    ที่เป็นราคาเอเชียนแฮนดิแคปรวมทั้งมีหลายราคาให้แก่ท่านได้เลือกพนันครบจากทุกลีกชั้นแนวหน้าของโลกไม่ว่าจะเป็นลีกเล็กหรือใหญ่ ทุกโซนทั่วโลก
    กีฬาฟุตบอลเล่นบอลสเต็ปเริ่มอย่างน้อยที่ 2 คู่แค่นั้น และก็พนันต่อบิลเริ่มที่เพียงแต่
    10 บาท เล่นง่ายมากยิ่งขึ้น มีบทวิเคราะห์ข้อมูลให้ และก็ อัพเดททุกรอบการแข่งขันชิงชัย
    รับชมเกมส์ถ่ายทอดสดคู่ที่ท่านเล่นได้ผ่านทางหน้าเว็บ สัญญาณเร็วกว่าสัญญาณโทรทัศน์ถึง 2 – 3 วินาที เฮก่อนคนไหนเพื่อนฝูง
    ชัดแจ๋วมองได้บนโทรศัพท์เคลื่อนที่
    เปิดรายการฟุตบอลเดิมพันมากยิ่งกว่าเจ้าอื่นๆมากกว่า SBOBET
    มีมวยไทยให้พนันแบบเปิดชูต่อยก ครบที่สุดในบรรดาเว็บไซต์ที่เปิดให้บริการมวยไทย

  183. UFA.BET เว็บตรง UFABET ยูฟ่าเบท (www.ufabet.com, http://www.betufa.com) เว็บพนันบอลออนไลน์ แทงสเต็ป กีฬา คาสิโนสด คาสิโนออนไลน์
    บาคาร่า รูเล็ต ไพ่เสือมังกร
    สล็อตออนไลน์ เกมยิงปลา ลอตเตอรี่ E Sport
    Virtual Sport มวยสเต็ป ด้วยระบบที่ทันสมัย ปลอดภัย คอมมิสชั่น(ส่วนลด)สูงสุด โปรโมชั่นแจกเครดิตฟรีแต่ละวัน ฝากเงิน เบิกเงิน เร็วทันใจด้วยระบบออโต้
    ให้บริการด้วยคณะทำงานมือโปร ลงทะเบียนยูฟ่าเบท และก็ ตอบปัญหา แต่ละวันผ่าน LINE @UFA100 แล้วก็
    ยูฟ่าฮอทไลน์ 099-456-1888 ตลอด 1
    วัน

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  185. แม้ว่าจะมีคนไม่ใช่น้อยที่หลงไปใช้บริการพนันบอลกับพวกบ่อนคาสิโนดุร้ายที่ไม่ได้รับการดูแลดูแลโดย ีufabet อันเนื่องมาจากบ่อนคาสิโนเถื่อนพวกนี้ได้จัดโปรโมชั่นชักพาให้คนที่อยากได้พนันบอลสามารถเข้ามารับโบนัสต่างๆคนจำนวนมากเมื่อมองเห็นโบนัสของพวกบ่อนคาสิโนหยาบคายก็เกิดความละโมบอยากได้เงินขึ้นมา จึงทำให้ตัดสินใจใช้บริการกับพวกบ่อนคาสิโนหยาบคายเหล่านี้ แต่ทราบไหมว่าพวกบ่อนหยาบคายไม่มีจรรยาบรรณเหล่านี้ นอกเหนือจากการที่จะไม่ยินยอมส่งเงินให้กับบ่อนคาสิโนใหญ่แล้ว เหล่านี้ยังถูกใจปิดเว็บไซต์หนี ไม่ก็ถูกใจทุจริตนักเดิมพัน ทำให้นักพนันเสียเงินเสียทองครั้งละมากมายๆเพราะว่าชอบชักนำให้นักพนันโอนเงินเข้ามาทีละจำนวนมากนักเดิมพันบางคนโอนเงินเข้าไปกระทั่งหมดตัว ด้วยเหตุว่าอยากได้เงินโบนัสจำนวนหลายชิ้น ก็เลยไม่ใช่เรื่องแปลกที่ผู้คนจำนวนไม่ใช้น้อยเสียเงินมากมายให้กับบ่อนคาสิโนเหล่านี้ พวกเราจึงอยากที่จะให้ท่านเลือกใช้บริการบ่อนคาสิโนที่มีการควบคุมความปลอดภัยผ่าน ีufabet เท่านั้น
    ท่านจะได้ไม่จำเป็นที่จะต้องถูกทุจริตและสามารถเล่นคาสิโนได้อย่างสบายใจเยอะขึ้นเรื่อยๆ ตัวอย่างก็มีให้มีความคิดเห็นว่าคนที่ชอบเล่นคาสิโนกับเว็บไซต์พวกนี้นั้น ชอบโดนโกงกันคือเรื่องธรรดาอยู่แล้ว
    เพราะเหตุว่าเว็บมิได้มีฐานะมั่นคงอะไรมาก เว็บไซต์ไม่ได้มีความพร้อมสำหรับเพื่อการให้บริการคาสิโนจริงๆแตกต่างจากเว็บไซต์ที่ส่งบิลเข้าคาสิโนจริงๆที่จะสามารถช่วยการันตีได้เลยว่าพวกเราจะไม่มีทางถูกโกง เพราะว่าเมื่อพวกเราชนะการพนัน บ่อนคาสิโนจะส่งเงินมาจ่ายให้กับเรา

  186. ด้วยความมุ่งมั่นตั้งใจและเอาใจใส่ทุกบริการอย่างทั่วถึง จนถึงเปลี่ยนมาเป็นเว็บที่ครบถ้วนสมบูรณ์แบบทั้งด้าน พนันบอล คาสิโน บาคาร่า SLOT สล็อต มวย ลอตเตอรี่ ไฮโล ไก่ชน มีครบจบที่เว็บเดียว พนันบอล กับเว็บพวกเราขั้นต่ำ 10 บาท พนันบอลสเต็ปเริ่มต้นที่ 2 คู่ สูงสุด 12 คู่ เปิดให้เล่นทุกลีกที่มีการชิงชัยทั่วทั้งโลก
    ราคาน้ำมากถึง 4 ตังค์ ทำกำไรได้มากกว่า บริการประทับใจตลอด 24 ชั่วโมง 365 วัน ไม่มีวันหยุด พร้อมระบบสมัครในลักษณะอัตโนมัติ ฝาก-ถอน ได้ตลอด 1
    วัน ทุกรายการสามารถทำได้ด้วยตัวท่านเอง แม้ติดปัญหาก็สามารถติดต่อคอลเซ็นเตอร์ได้ตลอด
    1 วัน เรามีกลุ่มผู้เชียวชาญที่รอให้คำปรึกษาแล้วก็เสนอแนะท่านตลอดระยะเวลา จนถึงทำให้ UFA888 กลายมาเป็น เว็บไซต์พนันอันดับ
    1 ของเมืองไทย ต่อเนื่องกันนานกว่า 10 ปี

  187. เมื่อท่านได้รับ Username และ
    Passwords กับทางทีมงาน Call Center
    แล้ว สามารถล็อกอินเหมาะหน้าเว็บไซต์ UFADEAL.COM เข้าหน้าเดิมพัน ยูฟ่าเบท มีระบบระเบียบลงทะเบียน และก็ ฝากถอนออโต้ ที่ล้ำยุค ทำรายการด้านใน 5 วินาที สมัครเล่นยูฟ่าเบท ท่านสามารถเลือกเล่นรายการพนันออนไลน์ได้ทุกหมวดหมู่
    ด้วยเหตุว่าทางเว็บไซต์เรานั้น มีครบทุกอย่าง ไม่ว่าจะเป็น
    รายการ กีฬาออนไลน์ ซึ่งประกอบไปด้วย การแทงบอล แทงบาส แทงมวย ไก่ชน เทนนิส และก็ ฮอกกี้น้ำแข็ง