3 Ways to Cut Denials in Your Podiatry Practice
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 findings — Justify the Q-modifier used with clear clinical evidence
Use the correct Q-modifier — Align 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 fully — Leave no gaps for payer review
Ensure ICD-10 codes precisely match documentation — Link correctly to CPT codes
Maintain audit-ready records — Eliminate 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 rigorously — Never let a claim expire
Establish systematic denial identification, analysis, and appeals — A 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.