Anthem BCBS plan that does not cover nail care or injections by a podiatrist. I saw a new patient on Friday 1/3/2024 with this plan. She paid out of pocket for her injection, but she advised that she is covered by her insurance plan when her orthopedist gives her injections in her knees. The patient paid out of pocket for the injection, but she understands her plan likely would pay for her orthopedist to give her injections in her feet instead of her podiatrist. No code listed: it just says "foot injection-routine footcare" as "not covered" for Podiatry-93
If the patient's insurance does not cover a service that you provide, the patient is responsible for payment of that service.
A steroid injection is not a form of "routine foot care" so communication with this payer may be needed to ensure the denial is accurate and confirm that they actually do not provide coverage of this service.
If the payer does, in fact, not cover any services provided by a podiatrist, then NYSPMA may choose to advocate for that to be changed.
Jeffrey D. Lehrman, DPM, FASPS, MAPWCA, CPC, CPMA
Certified Professional Coder
Certified Professional Medical Auditor
Lehrman Consulting, LLC