Podiatry medical billing: why routine foot care keeps denying
Most of what a podiatry practice loses to denials comes from routine foot care. Medicare treats nail and callus care as excluded, so those claims deny unless the claim proves the patient was medically at risk, right on the line, not buried in a chart note the payer never opens.
That is easy to get wrong. The risk findings, the systemic diagnosis behind them, and the physician managing that condition all have to be named on the claim, and any one of them missing is a denial. Most practices read a denial as a coding mistake. Usually it isn't. CMS found more than three-quarters of podiatry's improper payments come from thin documentation, not bad codes. The care was fine. The claim just didn't prove it.
Covered care also pays only once every 60 days, mycotic nail work turns on the symptom rather than the fungus, and what one payer covers another denies. For a solo podiatrist without a biller, that is a lot of ways to lose money you never see.
Altair is the done-for-you billing service, run by AI, backed by our expert in-house billers. We put what each payer needs on the claim and catch the ones that would deny before they go out.
Talk to us, and we will show you the routine foot care revenue you are losing.
Common questions
Why does Medicare deny so much routine foot care?
It treats routine foot care as excluded. It pays only when the claim shows the patient is medically at risk, with the right diagnosis and findings on the line and the treating physician named. Miss any piece and it denies, even when the care was justified.
Does a denial mean I coded it wrong?
Usually not. Most podiatry denials come from documentation that does not back the claim, not from the wrong code. The note has to prove risk before the claim goes out.
Can Altair do our billing if we have no biller on staff?
Yes. Altair is the done-for-you billing service for solo practices with no billing team, run by AI, backed by our expert in-house billers. We run the whole claim and work the denials.
Sources: CMS Routine Foot Care LCD L37643 (2024); CMS 2024 Medicare FFS Supplemental Improper Payment Data; Noridian JE Part B podiatry documentation guidance (2024).