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Comprehensive guide for podiatry medical billing and coding

by Nathan Zachary
medical billing services

The medical billing industry relies on insurance companies with their ever-changing rules and regulations. Physicians, including podiatry service providers, must adjust to the changing laws and rules of medical billing.

Medical coding related to coding and billing is a complicated process because medical necessity and medical billing have some limitations. Podiatry medical experts do not have enough time to deal with all these scenarios. If they try to do so, much of their time will be wasted. However, it would be better if they outsource their financial management task to firms offering reliable medical billing services.

What does podiatry billing mean?

Medical issues tolerated to the foot, including abnormalities and injuries, fall under the category of podiatry. Pediatrics, offering related services, deals with diagnosing the problems, medical complications, and surgeries required to treat.

Medicare does not deal with these categories because these conditions are changing time to time.

  • Foot skin cleaning, usage of ointment on the skin to prevent skin infections and rashes.
  • It also deals with cutting or removing the corns for smooth movements.

Podiatry billing has become more complicated in many ways because the process is very complex and takes more time to complete the coding accurately. Podiatry clinics also demand proper use of coding and modifiers.

A podiatrist can outsource their administrative task to third-party medical billing services. Medical billers should be able to handle, monitor, and analyze the metrics to enhance the process’s accuracy.

Common factors that affect podiatry reimbursement

When providing medical billing services in podiatry, the insurance provider may deny your medical claims for several reasons. For instance, an insurance company has stopped giving coverage to certain medical services.

Following are some liable factors for successful or optimal reimbursement.

Send a request to the insurance companies for approval:

Podiatry clinics face rejections when submitting a support request. To get their claim accepted, they need to double-check the guideline before approval

Write relevant codes

Writing irrelevant code is the common cause of rejections. The coders dealing with the coding must be experienced enough to put the related codes to avoid medical billing errors. He must know the CPT codes (Current Procedural Terminology codes). He must be sure of the national coverage determinations(NCDs).

Broad process

 In most cases, insurance providers do not accept the claims because the part he processes is more inclusive. For example, a physician might use the 11721, 11719, and G0127 codes to avert rejections.

How to use the appropriate modifiers for medical billing?

Using appropriate modifiers with the coding is an essential part of timely reimbursement. For example, it is sometimes difficult to define the services provided when diagnosing the ankle-foot or other relevant part of the leg. However, one has to add modifiers to add additional information.

Coding is also a complex phenomenon; one has to use appropriate codes and relevant to t

List of common modifiers for podiatry billing

  1. Q7-One class A Finding
  2. Q8-Two Classes B findings
  3.  Q9 – One class B and two class C findings 

HCPCS/CPT codes used in the billing of foot care are:     

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

Why should podiatry specialists outsource medical billing services?

Podiatrists are medical specialists specializing in diagnosing, treating, and preventing foot and ankle problems.

There are strict medical necessity requirements in place, as well as limitations on the foot problems that podiatrists can treat. For timely reimbursement, these healthcare providers must comprehend the appropriate codes for their services and keep their documentation ready. However, if they outsource podiatry billing and coding to expert medical billers and coders, they can pay heed to their medical practices

Podiatry billing and coding companies may handle all parts of claims processing, including evaluation, coding verification, establishing benefits eligibility, sending out claims, and tracking all accounts receivable. Professional coders and billers also provide documentation that is up to date with the most recent regulatory changes.

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