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3 Ways to Cut Denials in Your Podiatry Practice

Michael Caputo

Running a podiatry practice requires balancing patient care with financial management. In-house billing can lead to 15-30% higher denial rates compared to outsourcing to specialists. Podiatry-specific complexities like Q-modifiers and routine foot care exclusions mean small errors cause significant revenue loss.

1. Master the Q-Modifiers and Medical Necessity

Medical necessity is the most common denial reason. Medicare and most payers require treatment linked to systemic conditions such as diabetes, peripheral neuropathy, and peripheral vascular disease. Q-modifiers Q7, Q8, and Q9 communicate the severity of systemic conditions and physical exam findings to payers.

The Fix

Document Class A, B, or C findingsJustify the Q-modifier used with clear clinical evidence

Use the correct Q-modifierAlign it with the systemic condition's ICD-10 code every time

2. Strengthen Documentation to Support Every Code

Missing operative notes, incomplete progress notes, or failure to link diagnosis codes to procedures trigger denials. Common errors include incorrect codes for routine foot care or mismatched ICD-10 and CPT combinations.

The Fix

Document every procedure, diagnosis, and medical necessity justification fullyLeave no gaps for payer review

Ensure ICD-10 codes precisely match documentationLink correctly to CPT codes

Maintain audit-ready recordsEliminate compliance gaps proactively

3. Implement a Strict Timely Filing and Appeals System

Missing payer deadlines results in final, unappealable denials. Without structured appeals processes, significant revenue opportunities are lost.

The Fix

Track all payer submission deadlines rigorouslyNever let a claim expire

Establish systematic denial identification, analysis, and appealsA specialty team can accelerate payments by 10-14 days and reduce denials by 25-40%

Partner with JARALL to End the Struggle

In-house billing costs often exceed outsourcing expenses when accounting for staffing, errors, and lost revenue. JARALL Medical Management offers accurate coding, faster payments, and long-term financial stability — allowing providers to focus on patient care rather than paperwork.

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