Podiatry
Healthcare IT and billing built for a podiatry practice
Routine foot care coverage rules, DME dispensing and wound care documentation for podiatric practices.
Why podiatry is different
Podiatry billing is dominated by a single rule set: Medicare's routine foot care exclusion and the systemic-condition and at-risk documentation that creates an exception to it.
Healthcare SBC builds that documentation into the encounter (qualifying diagnoses, class findings and treating physician attestation) alongside orthotics and DME billing, wound care tracking and surgical global period management.
Common challenges
Where podiatry practices lose revenue
The billing and workflow problems specific to this specialty, and the ones generic systems handle badly.
Routine foot care exclusions
Nail and callus care is only covered with qualifying systemic conditions and documented class findings.
Q modifier requirements
Class findings must be documented and reported with the correct Q modifiers or claims deny.
Orthotics and DME billing
Custom orthotics and diabetic shoes carry strict documentation, supplier and delivery requirements.
Wound care documentation
Serial measurements, debridement depth and photographic documentation are required to justify ongoing care.
How we address it
Built for podiatry workflows
- Routine foot care qualification prompts with class finding capture
- Automated Q modifier application based on documented findings
- Orthotics and diabetic shoe workflows with delivery documentation
- Wound care flowsheets with measurement trending and photo capture
- Podiatric surgical global period tracking
Commonly billed codes in podiatry
A sample of the codes our podiatry coders work with daily.
- 11721Debridement of nails, six or more
- 11055Paring or cutting of benign hyperkeratotic lesion
- 97597Debridement of open wound, first 20 sq cm
- L3000Foot orthotic, custom fabricated
- 28285Correction of hammertoe
Codes shown for reference only. Verify against current code sets and payer policy.
Other surgical specialties
Orthopedics
Surgical global periods, DME, imaging and therapy billing unified for orthopedic groups.
General Surgery
Surgical scheduling, global period management and multi-facility coordination for surgical practices.
Ophthalmology
Eye code versus E/M selection, diagnostic imaging and surgical billing for eye care practices.
FAQ
Podiatry, frequently asked questions questions
- When is routine foot care covered by Medicare?
- Routine foot care is generally excluded, but is covered when the patient has a qualifying systemic condition, such as diabetes with peripheral neuropathy or peripheral vascular disease, and documented class findings, with the appropriate Q modifier reported and the treating physician relationship documented.
- Do you bill custom orthotics and diabetic shoes?
- Yes. These require specific prescribing documentation, supplier standards and proof of delivery. Our workflows capture each requirement at the point of dispensing so claims survive the documentation requests that routinely follow.
- How is wound care documented?
- Wound flowsheets capture serial measurements, tissue type, debridement depth and photographs over time, producing the objective progress documentation payers require to keep authorizing care.
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