In 2002, an OIG report found that Medicare inappropriately reimbursed podiatrists for Routine Foot Care Services that were found to be medically unnecessary and insufficiently documented. Since the OIG had not reviewed podiatry services since that report back in 2002, an audit was conducted to determine whether these compliance issues continued to exist during the subsequent audit period, 2019 and 2020. The audit examined whether podiatrists’ claims for Routine Foot Care Services related to a covered systemic condition complied with Medicare’s requirements. Of the 100 claims that were sampled, 49 claims for Routine Foot Care Services related to a covered systemic condition did not comply with Medicare requirements. As a result of the audit, the OIG opined that CMS’s oversight may not have been sufficient to prevent improper payments. The OIG estimated that of the $18.2 million paid by Medicare during the audit period, approximately $4.4 million did not comply with Medicare’s requirements.
by Justina DeBruzzi, Client Services Support at TLD Systems
December 10, 2025
By justina
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Did you know that your certified EHR has audit logs? Other software that your office uses may also have audit logs. You can enable audit logs to track activity on your network and on your computers.
In 2019, the OIG performed an audit of claims that were billed by podiatrists for E/M services. The audit examined whether podiatrists’ claims for E/M services billed with the 25 modifier, which indicates that the E/M service was significant and separately identifiable from a minor surgical procedure billed on the same date of service, one that has a postoperative global period of 0 or 10 days, complied with Medicare’s guidelines. One hundred (100) claims were sampled, and it was found that forty-four (44) claims did not comply with Medicare’s guidelines. The OIG estimated that $39.6 million of the $222.5 million paid by Medicare during the audit period was inappropriate. It was found that during the audit period, CMS’s oversight may not have been sufficient to prevent improper payments.
by Tahlia Brody, VP Client Services at TLD Systems
December 03, 2025
By tahlia@tldsystems.com
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I’d like to share a personal experience that has made me so grateful to have HIPAA. I understand and sympathize with that burden HIPAA places on providers and practices. At TLD Systems we do our best to minimize that burden, educate you about your responsibilities and help you to meet the HIPAA requirements. My experiences reminded me that HIPAA is about protecting patents, and at some point we are all patients.