Looking for Answers: L3000 Denials
I am not sure who can help me, so here goes:
I practice in Texas. For the last four weeks, Texas is paying for only one L3000 orthotic when it was billed as two line items, meaning L3000 RT on one line and L3000 LT on the second line. The diagnosis is correct, as it paid for one. We are appealing those claims. No help by phone, as they wont let us speak to a supervisor, and our clearinghouse refers us to the insurance company.
Denial codes are C-04 AND N-519.
We went to LYRIQ on Availity—where you can enter codes to see if it was the proper billing before the real claim is filed—and showed them that the way we billed was correct. But an AI search gives a different option. It appears that any bilateral HCPCA codes throws those two denial codes.
Is there anyone in the Podiatry Management community who can help us with this?
—George Bakatsas, DPM
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Keeping Your Cybersecurity in Check
October is Cybersecurity Awareness Month. With more elements than ever to consider, here are some basic things you should do now, at your office and on your personal devices.
—Melissa Thornton, CISSP, C|CISO
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Podcast: Stop Buying New Tech Before You Know What’s Broken
Nearly 70 percent of employees are using non-corporate accounts on workplace systems to access artificial intelligence platforms, according to Josh Schmidt, who is a partner at BPM leading cybersecurity and IT advisory work. At a medical practice, the next data leak could be as simple as an employee pasting patient information into an unapproved AI tool to save five minutes.
Schmidt recently joined Caila Cohen and Sven Jost, fellow BPM partners, for a conversation with Daniel Williams, senior editor and host of the MGMA Insights Podcast. Their subject was back-office modernization, but their warning was broader: Practices keep buying technology before defining the problem, automating fragmented workflows, and creating new security and reporting risks in the process.
Source: MGMA Stat
From the Magazine—October ‘26 Preview
Marketing Metrics That Matter
When it comes to collecting and analyzing data on your practice, the sky’s the limit. Everything can be collected and analyzed. How many patients came through the door? Done. Number of new patients per day, week, month, year? Done. Revenue per patient? Done.
If you have the kind of mind that craves more and more data, almost anything is up for grabs. But with limited time and resources, it makes much more sense to focus on specific metrics that support your goals.
This article will focus on the marketing metrics that will drive growth in your practice, which excludes many other business metrics that can and should be analyzed, but for different reasons.
What portion of your patients are routine foot care?
Keeping Things Running When EHR Goes Down
When Change Healthcare went dark in 2024, the damage reached far beyond one clearinghouse. In an informal American Medical Association survey of more than 1,400 respondents, 80 percent said their practices lost revenue from unpaid claims and 85 percent had to throw extra staff time at revenue cycle tasks. That was a vendor problem. When it's your EHR that goes down, the schedule, the chart and the prescription pad disappear with it.
Outages aren't rare, and they aren't always short…
Source: Physicians Practice
What to Do About Bunions
The venerable New York Times ran a piece about the best way for people with bunions to address their conditions. Among the experts cited are Robert Lee, DPM, chief of podiatric foot and ankle surgery at the University of California, Los Angeles, Santa Monica Medical Center.
Source: New York Times
GLP-1 Meds’ Effects on Joint Surgery
GLP-1 medications are doing something orthopedic surgeons have not seen: returning patients to the surgical candidate pool.
Patients who were previously excluded from joint replacement because of weight or uncontrolled diabetes are now reaching the BMI thresholds and metabolic benchmarks that make surgery viable—and some are losing enough weight that surgery can wait.
However, as the surgical candidate pool expands, a problem is following patients in. Rapid weight loss strips muscle along with fat, and muscle is what gets patients through rehabilitation. GLP-1 therapy without structured nutrition and strength training produces a thinner patient, but not necessarily a better surgical candidate.
Source: Becker’s Spine Review
Video: Let Me Help
David Farnen, DPM in the Nashville area, appeared in a local news segment that advised viewers to listen to their bodies when it's in pain or uncomfortable. He shared information about a few common foot problems people shouldn’t brush aside.
Source: NewsChannel5.com
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PM Pulse Classified Ads
30-Year Podiatry Practice—Kansas City, Missouri
Priced below appraisal. Established hospital-campus practice with strong referrals and 25,000 patient records. Fully equipped with digital X-ray and EMR. Staff staying on. Open four days, with demand for five. Retiring physician will assist with transition. A rare turnkey opportunity. Confidential inquiries: [email protected]
Traveling Podiatrist Needed—New York
Seeking a podiatrist for full-time or part-time work traveling to locations throughout New York, primarily assisted living facilities. Provide foot and ankle care. Starting pay: $100–$120 per hour, plus performance-based bonuses. Travel and gas expenses compensated. To apply, please call (516) 482-7775, option 5, ask for Avi for more information.
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