Podiatry Denials Masterclass: From Denied to Paid

Podiatry claims hit more edits than virtually any specialty —routine foot care stacks, same-day E&M, laterality and toe modifiers, frequency caps, and DMEs, and DME that’s authorized yet denied (even by MA plans). In this fast, practical session, learn front-end prevention and back-end appeal tactics that convert denials into clean, payable claims. 

What You Will Master 

• Crack NCCI Edits & Modifier Logic: When 25/59, 24/79, XS/XU apply; proper LT/RT and TA–T9 usage; bilateral (50 vs. LT/RT). 
• Bill Routine Foot Care Correctly (11055–11057, 11719–11721, G0127) with/without E&M and eliminate auto-denials. 
• Solve Frequency & Max-Benefit Denials: Map cap types, implement scheduler prompts, and document medical necessity for exceptions. 
• Win Orthotics & Podiatry DME Cases: Coverage vs. exclusion, required authorizations, and the evidence pack that pays. 
• Fix “Authorized but Denied” Lines: Pair claims with auth printouts and line-item linkage; leverage plan policy text in appeals. 
• Navigate Medicare Advantage Nuances for Orthotics/DME: Plan-specific determinations (not ABNs), notices, and routes. 
• Align Diagnoses with Procedures using key LCDs/Articles (e.g., L33636/A57759 for routine foot care; L33614/A56617 for debridement). 
• Eliminate Avoidable Edits: POS/unit limits, documentation gaps, and common coding pair conflicts. 
• Stop Eligibility Traps: LTC vs. mainstream routing, product/subplan selection, and critical payer-ID hygiene. 

Who Should Attend 
Podiatrists, Practice Managers, Billers/Coders, RCM Leaders, and Front-Office/Scheduling Teams. 

Educational content only; always confirm payer-specific policies before billing. No legal advice provided.