One of the biggest challenges podiatrists face is convincing insurance companies as to the necessity of the procedures that they perform. This requires precise podiatry medical billing and coding procedures in order to properly identify the exact treatment as well as the part of the body it covers. Your medical billing and coding efforts can be far more effective when you use a knowledgeable and experienced company such as EHealthSource Medical Management.
Podiatrists treat a very specialized set of symptoms, diseases, and conditions.
Some of these treatments are for routine care, whereas others are related to underlying issues, such as metabolic, neurologic or peripheral vascular disease, injury, ulcers, wounds, and infections.
Medicare specifically covers other podiatry services:
- Foot care for patients with chronic disease
- Treatments for wound care
- Hyperbaric oxygen therapy for hypoxic wounds and diabetic wounds of the lower extremities
There are other special billing guidelines for podiatry services:
Claims involving complicated conditions – These have 2 special requirements:
- They must document the name of the physician who diagnosed the complicating condition on the first submission of the claim.
- They must also carefully document the severity of the diagnosis, not just the diagnosis itself.
The nature of the service determines the exclusion of foot care, rather than theprovider who performs the service. This means that if a primary care physician performs a non-covered service, they won’t be reimbursed just because they aren’t a podiatrist.
Some payments are made on the basis of being integral to a covered procedure, whether or not the incidental service is excluded. These are regarded as incident to services.