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Insights That Move Healthcare

Expert perspectives on revenue cycle, risk adjustment, compliance, and healthcare strategy – designed to help providers, plans, and leaders make smarter operational and financial decisions.

Modifier 59: Why $4.4 Million in Podiatry Bil...

Podiatry billing services for foot and ankle surgery require a level of modifier precision that standard automated billing systems are not built to deliver – and the consequences of getting it wrong are measurable. OIG's December 2025 audit of podiatrists' Medicare claims found that 49 of 100 sampled claims did not comply with Medicare requirements, projecting approximately $4.4 million in improper payments across the full claim population [1].

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Podiatry coding review for Modifier 59 and XS documentation accuracy in multi-procedure foot and ankle surgery claims
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Pediatric Billing
June 20, 2025

AAP Releases 2025 Pediatric Billing G...

A healthy patient financial experience is critical for pediatric providers. Errors in pediatric billing, coding or docum...

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Pediatric Billing and Coding
October 08, 2024

Pediatric Billing and Coding Update f...

Pediatric billing and coding have undergone changes in recent years, and as provider offices head into 2025, it will be ...

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Market-based logistics efficiency
October 23, 2023

The Helping Kids Cope Act Means a Fre...

Finding new opportunities for pediatric billing is critical to maintaining the health of pediatric medical practices, an...

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Market-based logistics efficiency
June 07, 2023

Pediatric Medicine's Struggle with La...

Pediatric medicine supports some of the most vulnerable members of society. This makes shortages in the space even more ...

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Market-based logistics efficiency
January 31, 2023

Tips for Pediatric Billing and Coding...

As 2023 kicks off, now is a great time for pediatric revenue cycle leaders to take a step back and review ways they can ...

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