Good old 11721, the most common of all Podiatry codes, and also the one that provides the most angst among billing with Podiatrists. This code is responsible for a great deal of the Podiatric fraud cases in the country. There are some keys to avoiding being busted for fraud on 11721.
Do not be an outlier. Outliers are what gets people busted. If you are billing 11721 twice as much as any Podiatrist within a fifty mile radius you will get audited. No some times there are reasons for that like you are the only Pod doing Nursing Homes in the area. how can you avoid getting charged with fraud. This simple answer is variety. Do not bill 11721 on fifty patients in a row, we know that the odds of having 50 patients in a row that actually qualify for covered care is remote. Bill for non covered services on some, 11720 on others. Remember the more variety the less suspicious it looks. When you see a new patient defer from billing the 11721, remember you do not want to be an outlier is the 27 dollars really worth an audit.
Change your modifiers. I know of one Podiatrist that did nursing homes always used the PVD modifier. To the point he billed it twice as much as any other Podiatrist in the state. Change your modifiers you need to have variety. The key is to having detailed chart notes and bill variety. Singular billing sends up red flags whether you like it or not.