Billing, Coding, and Documentation for Digital Procedures: Avoid Audits & Clawbacks-Make Sure You are Doing it Right (and Left)
This program provides a comprehensive, compliance-focused review of billing, coding, and documentation for common digital procedures in podiatric practice. Emphasis is placed on accurate application of CPT coding definitions, adherence to National Correct Coding Initiative (NCCI) edits, and proper documentation to mitigate audit risk and prevent reimbursement clawbacks. Through procedure-specific examples—including nail surgery, hammertoe correction, tenotomy, digital amputations, hallux rigidus procedures, sesamoidectomy, Morton’s neuroma excision, and treatment of fractures and dislocations—participants will refine their ability to code complex encounters appropriately. The session also highlights common billing pitfalls, such as improper use of repeat procedure codes and misuse of pathology billing, while reinforcing best practices for compliant documentation aligned with current regulatory expectations.
1. Apply CPT coding definitions and NCCI edit principles to accurately report digital procedures and avoid improper code unbundling or duplication.
2. Differentiate appropriate versus non-compliant billing practices for common podiatric scenarios, including repeat nail procedures and pathology submission of nail specimens.
3. Evaluate documentation and coding requirements for digital surgical procedures—such as hammertoe correction, tenotomy, and soft tissue reconstruction—to ensure accurate reporting and reduce audit and recoupment risk.
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The information contained in this presentation does not establish a standard of care, nor does it constitute legal advice.
The information is for general informational purposes only and is prepared from a perspective to aid in understanding the pathology.
In accordance with the Council on Podiatric Medical Education's Standards and Requirements for Approval of Providers of Continuing Education in Podiatric Medicine, any relevant financial relationships with commercial interests of faculty, planning committee, or any others who have influence over the content of this educational activity must be disclosed to program participants. There are no conflicts of interest to disclose for this program
Commercial Interests: No commercial interest provided financial support for this continuing education activity.
In accordance with the Council on Podiatric Medical Education's Standards and Requirements for Approval of Providers of Continuing Education in Podiatric Medicine, any relevant financial relationships with commercial interests of faculty, planning committee, or any others who have influence over the content of this educational activity must be disclosed to program participants. There are no conflicts of interest to disclose for this program
CME Online is accredited by the Council on Podiatric Medical Education as a provider of continuing education in podiatric medicine. CME Online has accredited this activity for a maximum 1.5 continuing education contact hours.
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