Podiatry billing, handled with care
Where podiatry billing gets difficult
The issues we see most often, and the ones that quietly cost practices the most.
Routine foot care exclusions
Nail and callus care is usually excluded unless the patient has a qualifying systemic condition documented in detail.
Class findings and documentation
Coverage for routine care may depend on documented class findings and the date the patient was last seen by their treating physician.
Diabetic footwear requirements
Therapeutic shoes and inserts require certifying statements and supplier enrollment that differ from regular claims.
Surgical global periods
Foot and ankle surgeries carry global periods that affect billing for follow-up care.
How we handle them
Coverage-focused documentation review
We review routine care notes for systemic conditions, class findings and other details required by coverage policies.
Frequency tracking
We track the timing of routine care services so visits align with payer frequency limits.
DME workflow support
We help your team gather certifying statements and documentation for diabetic footwear before dispensing.
Surgical billing
We code procedures from operative notes and track global periods for follow-up visits.
Coding notes
General guidance only. Code sets update every year and payer policies vary, so we check current rules on every claim.
- Routine foot care coverage
- Medicare generally excludes routine foot care, such as nail debridement (11720–11721) and callus paring (11055–11057), unless the patient has a qualifying systemic condition. Coverage rules and frequency limits vary by contractor.
- Q modifiers for class findings
- Q7 indicates one Class A finding, Q8 two Class B findings and Q9 one Class B and two Class C findings. The documented findings should support the modifier used.
- Diabetic shoes and DME
- Therapeutic shoes and inserts are billed to the DME MAC and require a certifying statement from the physician managing the patient’s diabetes. The supplier must be enrolled as a DMEPOS supplier.
Podiatry billing questions
Get a free podiatry revenue audit
Send us a recent aging report and a sample of denials. We’ll show you what we’d fix first.