rcm solutions Podiatry facilities

Medical Billing And Revenue Cycle Management Solutions For Podiatry Facilities

Podiatrists diagnose, provide treatments, and perform surgeries for foot- and ankle-related problems. At StafGo Health, we specialize in providing medical billing and revenue cycle management (RCM) solutions made specifically for the unique needs of podiatry practices. We understand the challenges podiatrists face in billing, and our services cover the full spectrum of podiatry billing, from normal foot care to major surgeries.

Efficient CPT Code Management For Podiatry Practices With Stafgo Health

At StafGo Health, we have a team of certified coders well-versed in the application of accurate code for every procedure and service. It involves a wide range of CPT codes that correspond to both routine and complex procedures, requiring precise coding and documentation to ensure proper reimbursement. Commonly billed codes include 11055–11057 for paring or cutting of corns and calluses, 11719–11721 for trimming or debridement of nails, and 97597–97598 for wound debridement. For surgical procedures, codes such as 28285 (correction of hammertoe), 28308 (osteotomy of metatarsal), and 27650 (repair of Achilles tendon) are frequently used. Diabetic foot exams may utilize G0245–G0247, especially for Medicare patients. Podiatrists may also bill for evaluation and management (E/M) services using codes like 99202–99215, depending on the complexity and time spent.

Why Outsource Medical Billing And RCM To Stafgo Health For Your Podiatry Practice?

As a podiatrist, you provide treatment to patients with a range of foot- and ankle-related issues, from chronic problems like arthritis and diabetes complications to injuries and certain skin disorders. As a result, billing in-house can be time-consuming, costly, and potentially risky, particularly when it comes to staff retention. Hence, outsourcing your Medical Billing and RCM services to StafGo Health can help you to streamline your revenue processes, reduce claim denials, and help your team focus on what matters most—patient care.

Common RCM Challenges Faced by Podiatry Practices

Nail Procedures Billing Challenges—If the coding for nail trimming, avulsion, or matrixectomy is not documented properly, then there are high chances of denials, including medical necessity.
Complexity of Surgical Procedures - Podiatry billing involves coding for complicated procedures, like CPT and HCPCS coding for procedures like debridement, nail avulsion, and orthotic fittings. If documents do not meet the guidelines, then it often results in claim denials.
Frequent Audits and Medical Necessity Scrutiny - Podiatry is generally inspected by private payers or insurance companies. which can be time-consuming and complicated. Where medical necessity has to be justified by practices in detail, which is time-consuming and complicated.
Coverage Limitations and Patient Eligibility Issues - Some common podiatric services are excluded or have limited coverage in Insurance plans. Verifying patient benefits and checking exclusions can make the billing process slow.
High Denial Rates for Preventive and Routine Services - Certain services that are not covered unless linked to specific medical conditions, for example, callus removal, nail trimming, etc. This can result in high rejection rates without proper coding.
High Denial Rates for Orthotics and DME—Some podiatry practices provide durable medical equipment (DME), which makes billing more complex because it has separate guidelines, modifiers, and prior authorization requirements.

Solving Your Podiatry Practice’s Challenges with StafGo Health

Strict Documentation Review & Compliance - Our team helps your practice meet payer requirements by precisely reviewing all the notes to justify medical necessity, mainly for services like debridement and nail care, which are mostly audited.
Accurate Coding by Certified Experts - Our certified coders are specialists in podiatry-specific CPT, ICD-10, and HCPCS codes. They ensure every procedure is coded correctly and supported by appropriate documents.
Real-Time Eligibility & Benefits Verification - Our team thoroughly verifies the patient's insurance details to avoid delays and denials due to coverage limitations, exclusions, or authorization issues.
Denial Management & Appeals Expertise - Our team identifies the root cause of denials and works proactively to track and manage denied claims. We resubmit or appeal claims promptly to recover lost revenue.
Efficient DME Billing Support - Our team handles the complexities of DME billing, including modifiers, proper documentation, and payer guidelines, and in turn ensures timely reimbursements for orthotics and other equipment.
Nail Care Procedure Billing—Our team helps your practice code and document nail procedures accurately, avoiding common rejections tied to insufficient medical justification or missing modifiers.
Capture of Preventive Services Revenue— We help identify and implement billable preventive services such as fall risk assessments, diabetic foot exams, and smoking cessation counseling, unlocking new revenue streams.