Podiatry claims are denied more often for coverage policy than for coding. The routine foot care exclusion, and the systemic-condition exceptions to it, decide whether most of your work gets paid.
Generic billing services treat every claim the same. These are the patterns we look for first in podiatry practices.
Nail and callus care is excluded unless an at-risk systemic condition is documented and linked. The care is covered; the claim fails because the link is missing.
Class findings modifiers have to match what the note actually documents. Payers audit these heavily and recoup when documentation does not support the modifier.
What is covered in one jurisdiction is denied in another. Billing to a national rule when your MAC has its own is a recurring source of denials.
Many at-risk exceptions require documentation of the managing physician who treated the systemic condition. Missing that detail denies an otherwise valid claim.
Benefits and authorizations checked before the visit, not after the denial.
CPT, ICD-10 and modifiers validated against your documentation, with 100% audits for new clients.
Categorized by root cause, appealed with evidence, and fixed upstream so they stop recurring.
Oldest and largest first, with payments validated against your contracted fee schedule.
Payer enrollment and re-credentialing as part of the standard package, not an add-on.
Accuracy, turnaround and collections sent to you, not buried in a portal.
If your routine foot care claims are denying, the fix is usually documentation linkage rather than coding. We will review a sample free and tell you which.
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