Podiatry is one of the medical specialties, which concentrates on the diagnosis and treatment of the human feet and ankles. Podiatrists care about different conditions related to the foot such as heel spurs, toenails, fallen arches, foot/ankle injuries, and plantar fasciitis. Services offered by podiatrists should be paid by either insurance companies or the patients or by both. Podiatry medical billing and coding is a very critical part of many practices.
As far as podiatry billing services are concerned, it is able to collect the money efficiently from payers that are accountable for covering the services offered by podiatrists and patients. There are some services, which are not covered by payers, especially those which are not considered medically needed for appropriate foot care as per the Medicare Benefit Policy Manual (MBPM).
Let us discuss one by one which services are covered by payers and guidelines about the podiatry billing services:
An exception to podiatry services covered
There are specific foot care services that are not covered by Medicare, and there are chances to be covered under general third-party insurance. If you avail of some sort of foot care services that fall into this category then it is a waste of time to hassle with your insurance company for reimbursement. Which are those services?
Regular Foot Care
Services which are known as routine foot care and aren’t covered by Medicare are as follows:
- The removal or cutting of calluses and corns
- The cutting, clipping, trimming, and debriding of nails
- Other preventive and hygienic maintenance care like usage of skin creams to keep an even skin tone of bedfast or ambulatory patients, cleaning and soaking the feet, and Others.
The concept of flat foot is known as the condition in which one or more of the foot has flattened out. Devices or services guided towards the treatment or care of such conditions, like the prescription of supportive devices, are not covered.
Supportive Devices for Feet
Devices such as orthopedic shoes and others are generally not covered. Medicare can cover such shoes if it is a fundamental part of a leg brace. Moreover, its price is mentioned as part of the brace’s cost. Apart from this, a narrow exception allows coverage of special shoes and injects for particular patients with diabetes.
Podiatry Billing Services Guidelines
- Submission of claims requires to include the diagnosis and its intensity, the name of the podiatrist, and the visit date of a patient. Routine foot care offered by a non-podiatrist won’t be reimbursed. Services, which are covered by the payer will get reimbursed.
- Proper utilization of codes in order to avoid claims denials. Outsourcing billing services are necessary for a podiatrist that can manage the claim process.
- Avoid over-coding and follow coding procedures for filing claims. It is important to keep in mind that codes do not change for patient to patient.
- Carefully document any conclusive proof that a service’s non-professional performance might have been damaging to the recipient as a result of associated systemic illness. Saying that the recipient has a critical condition like diabetes does not of itself point out the criticality of the condition.
The above mentioned are some of the aspects and guidelines about podiatry billing services. From this, you may get a clear picture of services and illnesses, which are not covered by insurance companies.