The word podiatry might have been an unknown word to you. Lets’ define the term podiatry in the medical field.
“A doctor of podiatric medicine(DPM), a physician and surgeon who treats the foot ankle and related structures of the leg”
Podiatry billing and coding is a complex phenomenon, and the process goes on to a difficult level as the procedure moves to the climax. The medical authorities are on the way to determining whether the process is mandatory due to some medical issues or whether podiatry treatment is required in some situations. There are several reasons of revenue leakage, like poor knowledge, improper usage of modifiers, inappropriate write-offs, and old accounts.
However, having a basic understanding of Both CMS and AMA states as well as accurate knowledge of podiatry coding and billing will ease the process and help the insurance company to comprehend all the processes and medications. Resultantly, they will end up making fewer mistakes.
It is a better idea to take off some administrative burden, and hand over the podiatry billing and coding statements to a medical billing company to put more attention to the medical practice. This will help you focus on your practice and maximize the revenue in general.
Double-check the Insurance plans of a patient
Before you even begin the medical treatment, it is a better idea to verify the patient’s insurance plans and the insurance provider’s company background. To avoid the details or delayed payments, every podiatry expert should verify the patient’s insurance coverage to make sure that the patient is eligible for the insurance coverage or not.
The podiatry practice or the administrative department, dealing with the specific course, must verify all related information like insurance identity number, patient personal details including name, date of birth, residence address, codes related to a medical issue, insurance company contact details, and complete information related to particular coverage plans that have been offered to the patient.
Errors in the coding are the primary reason for delayed payments. Podiatry specialist needs to apply the relevant codes that specify or defines the relevant medical treatment. When doing CPT or HCPCS, it is essential to apply the appropriate ICD-10 codes.
Podiatry undergoes six ICD-10 codes which are further subcategorized into two HCPCS codes and eight CPT codes. The medical biller dealing with the codes should be efficient in writing codes according to the specific rules. Errors in codes may hiders the way to timely approval, or most of the times, resulted in the rejection of the claim.
Using an accurate Modifier during a billing
Putting the right modifier is another notable factor affecting the process of medical billing. The modifiers are the key factors to elaborate the information and procedure codes that are used on the date of the services. The “Q” modifiers have a co-relation with billing to track the categories of findings. For example, Class A (Q7), Class B (Q8), and Class C (Q9). Q7, Q8, and Q9 modifiers are used to express the patient medical condition in their finding. Q Modifiers are also used for codes like 1156,1155, 1119, 1121, or G0127, etc.
There are also other modifiers used to define some services i.e. GX and GZ modifiers. GX modifier is linked to liability and GZ refers to the denied claims. However, one should apply the accurate modifier to avoid the loss of revenue.
Tackle complex medical coding with custom coding
Sometimes, the doctors have to treat the patient which involves a more complex analysis that can’t be defined by specific codes. In these situations, the coders need to adopt the following measures to deal with the situation. For instance, Write the name of the physician, write the diagnosis date, name of the patient, and the severity of the medical situation.
Resubmit the claim if it is denied
Once the claim is denied due to any condition, don’t forget to check the reason for the denial. By doing so, you can fix the specific issue by reading the claim denial reason and resubmitting the claim within 30 days.
If you want to get your claims accepted or want to make more money in less time, following the appropriate coding process may speed up the process. No doubt, podiatry is a painstaking process taking cqre4 of the accurate coding process while insurance companies continuously change or update their regulations. To deal with this situation, you can take professional help from the physician revenue group.