Podiatry Billing Services in Colorado
Colorado's podiatry practices face unique billing challenges shaped by Anthem Blue Cross Blue Shield's commercial rules, Health First Colorado requirements, and Novitas Solutions Medicare policies. Our AAPC-certified coders specialize in both CO payer rules and podiatry coding complexity.
Why Colorado Podiatry Practices Need Specialized Billing
Colorado's healthcare market includes 16,000+ physicians, and podiatry practices here face a payer market dominated by Anthem Blue Cross Blue Shield on the commercial side and Health First Colorado on the public payer side. Medicare claims are processed through Novitas Solutions, which applies its own Local Coverage Determinations that directly affect podiatry procedure coverage and medical necessity requirements. Generic billing teams without CO specific knowledge leave revenue on the table.
Podiatry billing itself is complex. Podiatry billing is uniquely complex because Medicare excludes routine foot care by default. Coverage requires documented systemic conditions (diabetes, peripheral vascular disease, peripheral neuropathy) that create a class finding making routine care medically necessary. Diabetic foot care certification (LOPS testing), nail debridement codes 11720-11721, orthotics L-codes, and the Medicare Therapeutic Shoe Program (A5500-A5513) each have their own coverage criteria. When you combine this coding complexity with Colorado's specific payer rules, authorization requirements, and 3 Health First Colorado managed care plans that each have their own billing rules, you need a team that understands both dimensions. Go Medical Billing provides that expertise at 2.49% of collections, serving podiatry practices from Denver to Boulder and across Colorado.
Top CPT Codes for Podiatry in Colorado
Our CO coders handle these podiatry codes daily, applying Novitas Solutions Medicare rules and Anthem Blue Cross Blue Shield commercial policies to each claim.
Colorado Payer Challenges for Podiatry
Every CO payer has specific rules for podiatry claims. Here's how we navigate them.
Anthem Blue Cross Blue Shield Podiatry Claims
Anthem Blue Cross Blue Shield processes the largest share of Colorado commercial podiatry claims. We know their CO specific fee schedules, prior authorization requirements for podiatry procedures, and their appeal timelines when claims are denied. Medicare does not cover routine foot care (nail trimming, callus removal) unless a qualifying systemic condition and class finding are documented.
Health First Colorado Podiatry Billing
Health First Colorado routes podiatry patients through 3 managed care plans: Colorado Access, Rocky Mountain Health Plans, Denver Health. Each MCO has its own podiatry authorization and billing rules that we manage.
Medicare (Novitas Solutions) Podiatry Coverage
Novitas Solutions processes Medicare podiatry claims in Colorado with its own Local Coverage Determinations. We navigate Novitas Solutions's policies around diabetic foot care certification to prevent medical necessity denials.
Denial Prevention for Colorado Podiatry
Common podiatry denials in Colorado include medicare does not cover routine foot care (nail trimming, callus removal) unless a qualifying systemic condition and class finding are documented and medicare requires an annual lops (loss of protective sensation) certification and a prescribing physician's statement for diabetic foot care coverage. Our team catches these issues before submission and appeals aggressively with CO payer-specific documentation when denials occur.
Get Expert Podiatry Billing in Colorado
Free billing assessment for your CO podiatry practice. See where revenue is leaking.
What We Handle for Colorado Podiatry Practices
Colorado Podiatry Billing Cost Comparison
Hiring an in-house biller with podiatry expertise in Colorado costs $40K-$55K annually in salary alone. Add benefits, software, clearinghouse fees, and office space, and the true cost is even higher. At 2.49% of collections, Go Medical Billing provides an entire team of AAPC-certified podiatry coders and CO payer specialists for a fraction of that cost.
$40K-$55K
In-House Biller Salary
+ benefits, software, space
2.49%
Go Medical Billing Rate
Full team, all services included
60-80%
Typical Cost Reduction
With better results
Related Pages
Explore our Colorado and podiatry billing resources.
Frequently Asked Questions
Fix Your Colorado Podiatry Billing
Call 888-701-6090 for a free billing assessment specific to your CO podiatry practice. We'll show you where revenue is leaking and how to fix it.