Your wound care documentation says 97597. Your wound measurements say otherwise.
Wound debridement documented with the wrong depth code, orthotic dispensing without the right modifiers, and diabetic foot exams missing the elements Medicare requires. Fifteen free minutes is enough to tell you which one is costing you the most.
15 minutes. Custom financial scorecard for your practice.
At a glance
Is This Right for You?
This is for podiatry practice owners who:
Want ongoing financial oversight? Our Fractional CFO service for podiatry practices may be a better fit.
What We Analyze
Where Podiatry Practices Lose Revenue
We trace every dollar from claim submission to bank deposit in your podiatry practice.
Diabetic & Routine Foot Care Billing
- •LOPS G-code documentation compliance (G0245 initial, G0246 follow-up, G0247 routine care)
- •Vascular and sensory assessment documentation review
- •Routine vs medically necessary care differentiation
- •Class finding modifier accuracy (Q7, Q8, Q9) for at-risk patients
Wound Care Coding
- •Debridement code selection audit (97597/97598 vs 11042-11047)
- •Wound care management coding (97607/97608)
- •Documentation sufficiency for wound size and depth
- •Active wound care vs maintenance care billing
DME & Orthotic Billing
- •Custom orthotic medical necessity documentation review
- •Medicare DME modifier compliance (KX, GA, GY) and ABN handling
- •Prior authorization tracking for DME
- •Lab relationship documentation requirements
Procedure Coding Accuracy
- •Nail debridement coding review (routine vs medically necessary)
- •Surgical procedure coding accuracy
- •Office procedure charge capture
- •Modifier usage for bilateral and multiple procedures
Results
What Podiatry Practices Recover
| Finding | Typical Outcome |
|---|---|
| PA restructuring | Adjusted schedule and panel to generate $217K in collections, turning -$30K into +$35K annual contribution |
| Wound care coding | $42,000 in additional annual revenue from proper code selection |
| Orthotic denial reduction | $28,000 recovered through documentation improvement and denial resubmission |
Case Study
Real results from a practice like yours
2-podiatrist practice with one PA, two locations, significant wound care and diabetic patient base. Revenue was $1.1M but had been flat for four years despite adding a PA two years ago. The owner assumed Medicare rate cuts were to blame but had not analyzed the real drivers.
What we found:
- •The PA was generating $165K in collections but costing $195K when fully loaded (salary, benefits, supervision time, malpractice). A net drag of $30K per year that was invisible in combined financials
- •Wound care debridement was coded as 97597 (first 20 sq cm) on 92% of cases, even when wound sizes documented in the chart supported higher-level codes. An estimated $42K per year went uncollected
- •Custom orthotics were billed to insurance 180 times per year but denied 34% of the time due to documentation gaps. Recovered denials represented $28K in revenue
- •Diabetic LOPS foot exams (G0245 initial / G0246 follow-up) were missing the required vascular assessment documentation on 45% of charts, creating compliance risk and denial vulnerability
The results
Adjusted schedule and panel to generate $217K in collections, turning -$30K into +$35K annual contribution
PA restructuring
$42,000 in additional annual revenue from proper code selection
Wound care coding
$28,000 recovered through documentation improvement and denial resubmission
Orthotic denial reduction
“I blamed Medicare for our flat revenue. Turns out we were leaving $70K on the table in wound care coding and orthotic denials alone — and our PA was actually costing us money.”
— Practice Owner, Mid-Atlantic
Common Questions About Revenue Cycle Analysis for Podiatry Practices
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