Podiatry · Flagship specialty
Routine foot care denials. DME audit risk. Modifier confusion. We handle podiatry billing the right way.
Podiatry has the messiest documentation rules in outpatient medicine — and one of the highest audit exposures. We've built our flagship specialty around it. If you're running a podiatry practice, you'll notice the difference inside the first month.
Who this serves: Independent podiatry practices, multi-location podiatry groups, and podiatry teams inside skilled nursing facilities and hospital-based outpatient departments.
Podiatrists aren't paid for bad billing — they're paid for documentation that matches billing. Miss a modifier 59, lose the claim. Call a nail debridement "routine" when it was "at-risk foot," trigger an audit. Bill DME without the LCD-compliant chart note, get a recoupment letter six months later.
Most billing vendors treat podiatry like any other specialty. They code the encounter, submit the claim, and when it denies, they kick it back to your front desk to "get more documentation." Meanwhile, your RAC exposure is growing with every at-risk foot exam where the chart doesn't match the code.
We chose podiatry as our flagship specialty for a reason: the margin between a well-billed practice and a poorly-billed one is wider here than anywhere else in outpatient medicine. Often six figures a year. Usually invisible until it isn't.
What separates a specialty-fluent biller from a generalist.
Nail and skin care
- 11055 / 11056 / 11057 — paring vs debridement coding
- 11719 / 11720 / 11721 — nail trimming vs debridement by count
- At-risk-foot documentation (LOPS, neuropathy, vascular disease)
- Routine vs medical-necessity documentation
Wound care
- 11042–11047 — debridement depth-of-tissue coding
- 97597 / 97598 — selective wound debridement
- Q-codes for skin substitutes (Q4100 series)
- Chart-note templates that hold up under medical-review audit
DME billing
- Custom orthotics (L3000 vs L3020 vs A5500-series)
- AFOs, CROW walkers, diabetic shoes, post-op boots
- LCD-compliant chart notes — the make-or-break of DME billing
- Proof-of-delivery and supplier standards
Surgery
- Foot and ankle surgery coding (28xxx series)
- Ankle fracture reductions (27810–27825)
- Modifier 51 / 59 / 79 / XS discipline
- Bilateral procedure rules — the bundling trap
- Global period management
Advanced
- Low-dose radiation therapy (when performed in-practice)
- MIPS reporting calibrated to podiatrist measure sets
- APMA-aware coding conventions
Podiatry-fluent coders
Whoever touches your DME claim has worked DME. Your 11721 coder has coded 11721s for years.
Audit defense built in
Compliance & audit is part of the flagship podiatry package, not an upsell. Given podiatry's audit exposure, this is non-negotiable.
CPA-led reporting
Your monthly packet tells you which CPT codes are under-collecting, which payers are slow-paying, and which providers are leaving revenue on the table. GAAP-readable.
Partner, not acquirer
Pacesetter asks for equity. We don't. We run your operations; you keep your practice.
Podiatry is one of the top three audit-targeted specialties in outpatient medicine.
OIG, RAC, and commercial payer audits hit podiatrists disproportionately — especially on routine foot care, at-risk-foot exams, DME, and wound care. A billing company that doesn't also handle compliance is a liability. We build audit readiness into every claim — LCD-compliant documentation templates, monthly chart-review sampling, and a defense file for every high-risk code category. When (not if) the audit letter arrives, you hand it to us.
Sun Health Podiatry — four locations, multi-provider
18% → 4.5%
Denial rate
45 → 24
AR days
82% → 96%
Clean-claim rate
91% → 106%
Net collections
Six-month recovery of $420,000. Same practice, same volume, different billing discipline.
Read the full case studyDays 1–30 · Audit
We pull the last 12 months. Map denials by CPT and payer. Flag every high-audit-risk code category. Check DME documentation sampling. You get a written report on day 10 — before any contract.
Days 31–60 · Take over
We run submission, posting, denial work, and DME billing in parallel with your current flow. Compliance sampling starts. First monthly packet lands on day 60.
Days 61–90 · Lift
Clean-claim rate at or above 96%. Denial rate below 5%. AR days trending down week over week. You're billing more correctly than you've ever billed — without having added a single staff member.
Ownership structure doesn’t change the billing mechanics. The practice is the unit we serve.
- Independent solo and small-group podiatry practices (1–10 DPMs)
- Multi-location podiatry groups (including DME-heavy practices)
- Podiatrists providing services inside skilled nursing facilities
- Hospital-based podiatry departments with practice-like P&L and payer contracting
Free audit
Curious how much you're leaving on the table in podiatry?
Our free 30-day audit tells you — specific codes, specific payers, specific dollar amounts. No contract. You keep whatever we find.