Keeping up with annual coding updates can be a challenge for any medical practice — but for podiatrists, even small CPT or ICD-10 revisions can have a big impact on reimbursement and compliance. Every January, the AMA and CMS release changes that affect how foot and ankle care services are documented, billed, and paid.
At JARALL Medical Management, we help podiatry practices stay ahead of these changes — preventing costly denials and ensuring every claim is coded accurately the first time. Below, we’ve outlined ten key podiatry coding updates and trends to watch this year, along with insights on how to adapt your billing process for success.
1. Expanded Evaluation and Management (E/M) Guidelines
The latest E/M coding revisions now extend to outpatient and inpatient visits, simplifying documentation requirements but changing how complexity is determined. For podiatrists, this means focusing on medical decision-making rather than time-based reporting.
Tip: Make sure your clinical documentation supports the medical necessity behind each encounter — especially for follow-ups and diabetic foot exams.
2. New Codes for Skin Substitute Grafts and Cellular Tissue Products
CMS has introduced updated HCPCS codes to better differentiate between types of skin substitutes used in wound care. Since podiatrists frequently treat chronic ulcers, these changes directly affect billing accuracy.
Tip: Verify that your billing software and clearinghouse have the new code set loaded, and update your charge sheets to prevent denials.
3. Revised Coding for Nail Debridement and Avulsion Procedures
Several CPT descriptions for nail-related procedures have been clarified to distinguish between partial vs. complete removal and to define medical necessity more clearly.
Tip: Include detailed clinical notes — such as infection presence, pain level, and patient history — to justify medical necessity for debridement.
4. Modifier Updates: Proper Use of Q7–Q9 Remains Critical
While the modifiers themselves haven’t changed, CMS has tightened enforcement around their use for routine foot care claims. Missing or incorrect Q-modifiers continue to be one of the most common causes of denials.
Tip: Conduct a quarterly audit to confirm your team is applying Q7–Q9 correctly, aligned with diagnosis codes for qualifying systemic conditions.
5. New ICD-10 Codes for Diabetic Foot Complications
Recent ICD-10 revisions now include more granular codes for diabetic foot ulcers and neuropathic complications.
Tip: Train your providers to document specific ulcer locations, severity, and laterality — these details are key for accurate code selection and reimbursement.
6. Telehealth Coverage Extensions for Podiatrists
Telehealth remains partially covered for certain follow-up visits and patient evaluations. Some payers have expanded their coverage lists to include additional podiatry-related services.
Tip: Confirm payer-specific telehealth policies before billing. Some carriers require modifiers 95 or GT, depending on the platform used.
7. Bundling Changes for Orthotic and Durable Medical Equipment (DME)
CMS has updated bundling edits that affect when orthotic devices and offloading boots can be billed separately from wound care visits.
Tip: Review payer rules carefully — incorrect bundling can lead to recoupments months after reimbursement.
8. New Guidance on Local Coverage Determinations (LCDs)
Several Medicare Administrative Contractors (MACs) have revised LCDs related to foot care, wart removal, and mycotic nail treatment. These changes impact coverage criteria and supporting documentation requirements.
Tip: Stay up-to-date with your region’s MAC website or work with a billing partner like JARALL that tracks LCD updates for you.
9. CPT Additions for Advanced Imaging and Biomechanical Assessment
With podiatrists increasingly incorporating diagnostic imaging and gait analysis technology, new and revised codes have been added to capture these services more accurately.
Tip: If your practice uses digital radiography or biomechanical assessment tools, confirm that you’re using the correct codes to avoid underbilling.
10. Increased Scrutiny on Incident-To Billing
CMS has clarified that “incident-to” billing under a physician’s NPI requires direct supervision and documentation that meets specific criteria.
Tip: Ensure your staff and billers understand when it’s appropriate to bill under a physician versus a non-physician provider to avoid compliance issues.
What These Changes Mean for Podiatry Practices
Even a small coding error can delay payments or trigger payer audits. This year’s updates emphasize specificity, documentation accuracy, and compliance — three areas where many podiatry practices struggle when managing billing in-house.
If your team isn’t confident in navigating these changes, it’s easy to fall behind. JARALL’s podiatry-focused billing experts continuously monitor code updates, payer rules, and audit trends — ensuring every claim is accurate, timely, and compliant.
How JARALL Keeps You Ahead
Our team doesn’t just process claims — we partner with podiatry practices to help them thrive. Here’s how JARALL makes coding changes simple to manage:
• Proactive updates: We review and implement all annual CPT and ICD-10 changes for you.
• Training and education: Your staff receives ongoing guidance on modifier use, documentation standards, and payer updates.
• Audit support: We identify risk areas before they lead to denials or recoupments.
• Compliance confidence: Our 98% clean claim rate means fewer rejections and faster reimbursements.
Final Thoughts
Staying current with podiatry coding updates is essential for keeping your revenue cycle strong and compliant. The good news? You don’t have to navigate it alone.
At JARALL Medical Management, we specialize in helping podiatrists simplify billing, reduce denials, and maximize reimbursements — all while freeing up time to focus on patient care.
🗓 Schedule a free podiatry billing review today and make sure your practice is ready for the latest coding changes.