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Top 10 Podiatry Coding Changes to Watch This Year

Michael Caputo

Annual coding updates pose real challenges for podiatry practices — CPT or ICD-10 revisions directly affect reimbursement and compliance. Changes arrive each January from AMA and CMS, and staying ahead of them is critical.

1. Expanded E/M Guidelines

Latest revisions extend to outpatient and inpatient visits, shifting focus toward medical decision-making over time-based reporting.

TipDocumentation must support medical necessity, especially for diabetic foot exams

2. New Skin Substitute Graft Codes

Updated HCPCS codes better differentiate wound care products, improving specificity in billing.

TipUpdate billing software and charge sheets with the new codes immediately

3. Revised Nail Debridement/Avulsion Codes

CPT descriptions have been clarified for partial vs. complete removal procedures.

TipDocument infection presence, pain level, and patient history thoroughly

4. Modifier Q7-Q9 Enforcement

CMS has tightened enforcement on Q-modifiers. Missing modifiers remain a top denial cause for podiatry practices.

TipRun quarterly audits on modifier application to catch errors before payers do

5. New Diabetic Foot Complication ICD-10 Codes

More granular codes are now available for ulcers and neuropathic complications.

TipDocument ulcer location, severity, and laterality with precision

6. Telehealth Extensions

Some payers have expanded podiatry telehealth coverage, opening new billing opportunities.

TipConfirm payer policies; modifiers 95 or GT may be required

7. Orthotic/DME Bundling Changes

Updated bundling edits affect when devices can be billed separately from related services.

TipReview payer rules carefully to avoid recoupments

8. Revised Local Coverage Determinations (LCDs)

MACs have revised LCDs covering foot care, wart removal, and mycotic nails.

TipMonitor your region's MAC website regularly for updates

9. Advanced Imaging/Biomechanical Assessment Codes

New codes have been added for diagnostic imaging and gait analysis procedures.

TipVerify correct codes to avoid underbilling for these services

10. Incident-To Billing Scrutiny

CMS has clarified that incident-to billing requires direct supervision and specific documentation standards.

TipEnsure staff understands when to bill under physician vs. non-physician provider

Key Takeaway

This year's updates emphasize specificity, documentation accuracy, and compliance. Staying on top of these changes is the difference between clean claims and preventable denials. JARALL maintains a 98% clean claim rate through proactive code updates, staff training, audit support, and ongoing payer monitoring.

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