Denied claims aren’t just paperwork—they’re lost revenue. Every denial means more staff time spent fixing errors, more delays in cash flow, and sometimes, money that’s never recovered. Podiatrists, in particular, deal with high denial rates due to the specialized and sometimes misunderstood nature of foot care. 

So how can you reduce denials and make sure claims are paid the first time? Let’s look at five strategies. 

1. Double-Check Coding 

Modifiers like Q7, Q8, and Q9 are unique to podiatry and often trigger denials if used incorrectly. These modifiers indicate severity of peripheral vascular disease and are essential for proving medical necessity. If your team isn’t trained on their correct use, you’re likely seeing unnecessary denials. 

Another common mistake is miscoding routine foot care as covered services. For example, trimming nails without proper diagnosis documentation is usually non-covered. Pairing it with conditions like diabetes or neuropathy can change coverage entirely. Precision matters. 

2. Verify Coverage Up Front 

Not all services are covered equally. Medicare and commercial plans often exclude “routine foot care” unless linked to a medical condition. Imagine a patient assumes coverage and then gets a surprise bill. This not only hurts your collections—it damages patient trust. Verifying eligibility before the appointment helps both your practice and your patients avoid misunderstandings. 

3. Document Thoroughly 

Payers want proof. A vague note like “nail care performed” isn’t enough. Documentation should connect the procedure to a diagnosis code and show medical necessity. For example: “Debridement of mycotic toenails performed due to pain and difficulty ambulating. Patient has Type 2 diabetes with neuropathy.” That level of detail turns a denied claim into an approved one. 

4. Track Common Denials 

Keep a simple log of denials and their reasons. Patterns often emerge with certain insurers or codes. For instance, if you notice one insurer frequently denying claims tied to orthotics, you can proactively adjust documentation or appeal more strategically. 

5. Appeal Aggressively 

Too many practices give up after the first denial. But appeals often succeed when backed by thorough documentation. Having a structured appeal process—complete with templates and timelines—can help your practice reclaim revenue that others write off. 

How A Step Above Health Mgmt Supports Practices 

We take denial prevention seriously. Our team uses analytics to track trends, spot recurring issues, and fix them before they become systemic problems. Plus, we handle appeals efficiently, ensuring you recover revenue that might otherwise be lost. With us, you’re not just cleaning up denials—you’re preventing them from happening in the first place. 

By partnering with a podiatry-focused billing team, you can expect cleaner claims, fewer denials, and a healthier bottom line.