Podiatry Articles and Resources
2020 Podiatry Cheat Sheet
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News and Important Information
Therapeutic Shoes for Individuals with Diabetes - Medicare Benefit Policy Manual Chapter 15, 140
CPT Procedure Codes
ICD-10-CM Diagnosis Codes
ICD-10-CM Diagnosis Codes
List of Toe Modifiers
Find-A-Code's Tools & Resources
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Step-by-step coding from all major code sets.
Pro Fee Calculator
Verify Medicare Reimbursement and UCR Fees for Professional Services
NCCI Edits Validator Tool
Avoid denials by checking codes for any errors
Commercial Payer Policy Search
Instantly search through over 34,000 payer policies for codes or keywords
NPI Look-Up Tool (National Provider Identifier number)
Durable Medical Equipment Resources
DME Topics Page
Find-A-Codes DME Topics Page
DMEPOS Product Search
Quick Product and HCPCS Code Look Up Tool
Use this tool to create and complete checklists for DME
Standard Written Order (SWO)
Dates of Service on or After January 1, 2020
Noridian Diabetes Information Page
Diabetic, Diabetes Self-Management Training (DSMT) and Medical Nutrition Therapy (MNT)
Additional Links and Resources
Noridian: Podiatry Resources
Noridian JE Part B Podiatry Resources
Medicare Podiatry Services
MLN Fact Sheet Medicare Podiatry Services
MLN Fact Sheet
Education on Medicare coverage of podiatry services.
Drugs and Biologicals Pub-100 Ch 17
Drugs and Biologicals Pub-100 Ch 17
Billing Requirements for OPPS
Billing Requirements for OPPS Providers with Multiple Service Locations
Podiatry Specialty Manual
CMS- Clinical Data Elements
Select the title to see a summary and a link to the full article.
October 7th, 2020
Stay out of Trouble — Understand the Qualified Medicare Beneficiary (QMB) Program
Published October 7th, 2020|
To assist low-income Medicare beneficiaries, CMS created the Qualified Medicare Beneficiary (QMB) program; a Medicaid benefit which pays for Medicare deductibles, coinsurance, or copays for any Medicare-covered items and services for Medicare Part A, Part B, and Medicare Advantage (Part C). Providers/suppliers are prohibited from billing premiums and cost sharing to Medicare beneficiaries who are enrolled in QMB.
July 14th, 2020
Are NCCI Edits and Modifiers Just for Medicare?
Published July 14th, 2020|
The National Correct Coding Initiative (NCCI) edits were developed by CMS to help promote proper coding and control improper coding that leads to incorrect payments with part B claims. It is important to understand that NCCI edits do not include every possible code combination or every type of un-bundling combination. With that ...
April 8th, 2020
ICD-10-CM Official Coding and Reporting Guidelines Updated for COVID-19
Published April 8th, 2020|
The ICD-10-CM Official Coding and Reporting Guidelines have just been updated to include COVID reporting. Additional information beyond the previously released interim guidelines are included. These are the rules that should be followed for claims submission. The notice states that this is for April 1, 2020 through September 30, 2020.
March 31st, 2020
CMS-Coverage for Therapeutic Shoes for Individuals with Diabetes
Published March 31st, 2020|
Therapeutic shoes and inserts can play a vital role in a diabetic patient's health. Medicare may cover one pair every year and three pairs of custom inserts each calendar year if the patient qualifies and everything is handled correctly. Medicare Benefit Policy Manual explains what is needed for a person with diabetes to ...
March 5th, 2020
The difference between Jones and Proximal Diaphyseal Fractures of the Fifth Metatarsal (2018-10-23)
Published March 5th, 2020|
Distinguishing the difference between Jones and Proximal Diaphyseal Fractures of the Fifth Metatarsal can be complicated, here are some examples from PubMed; A Jones fracture currently is defined as an acute fracture of the fifth metatarsal at the junction between the proximal diaphysis and metaphysis of the fifth metatarsal without distal extension beyond the fourth to fifth intermetatarsal articulation. Tuberosity avulsion fracture (also known as pseudo-Jones fracture or dancer's fracture) A proximal diaphyseal fifth ...
August 9th, 2019
The OIG Work Plan: What Is It and Why Should I Care?
Published August 9th, 2019 - Last Review/Update August 14th, 2019|
The Department of Health and Human Services (HHS) founded its Office of Inspector General (OIG) in 1976 and tasked it with the responsibility to combat waste, fraud, and abuse within Medicare, Medicaid, and the other HHS programs. With approximately 1,600 employees, HHS OIG is the largest inspector general's office within ...
July 12th, 2019
5 Ways to Minimize HIPAA Liabilities
Published July 12th, 2019 - Last Review/Update July 30th, 2019|
Last year was historic for HIPAA enforcement. The HHS Office of Civil Rights collected a record $23.5 million in settlements and judgments against providers guilty of HIPAA violations. To avoid becoming part of that unwanted statistic, it’s important to pay extra close attention to five key areas of HIPAA vulnerability. Take ...
April 23rd, 2019
OIG Announces New Review For Medicare Part B Payments for Podiatry and Ancillary Services
Published April 23rd, 2019|
Due to prior OIG work identifying inappropriate payments for podiatrists and ancillary services, the OIG announced in Feb 2019 they will begin a new review starting in 2020. The OIG stated they will review Medicare Part B payments to determine if medical necessity is supported in accordance with Medicare requirements. Part of the ...
January 4th, 2019
Nine New Codes for Fine Needle Aspirations (FNA) in 2019
Published January 4th, 2019|
If your practice performs a lot of fine needle aspirations (FNA), you probably have the code options memorized (10021 without image guidance and 10022 with image guidance). However, the 2019 CPT codes now include nine (9) new FNA codes (10004-10012), one deleted FNA code (10022) and one revised FNA code ...
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Advanced Beneficiary Notice of Noncoverage (ABN) Form Instructions ToolBilateral Surgeries: Claim SubmissionCommonly Used Medicare Modifiers - GA, GX, GY, GZDME Billing guideanceMedicare Part B Clinical Laboratory Fee ScheduleNoridian Fee-for-Time Compensation Arrangements and Reciprocal Billing PoliciesNoridian: Allowed Amount ReductionsPhysician Assistant (PA) Resources NoridianSummary of the HIPAA Privacy Rule by HHSUtah Department of Licensing - Podiatry
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