AI Scribe for Podiatrists (DPM)
Captures the focused diabetic foot exam — vascular pulses and ABIs, monofilament results site-by-site, Wagner ulcer staging — and writes the Medicare medical-necessity language that controls reimbursement for routine nail and callus care. Half the cost of generalist scribes like Heidi or Suki.
Documentation for every podiatry visit
From routine diabetic foot care to Charcot reconstruction and ankle arthroscopy, the same scribe handles the full DPM workload.
Diabetic Foot Exam
Comprehensive vascular (DP, PT pulses, ABI), neurologic (10-gram monofilament at 10 sites, vibration), dermatologic (skin, nails, ulcers staged by Wagner) — the full ADA annual exam.
Ingrown Toenail
Onychocryptosis grading, partial vs total matrixectomy planning (CPT 11750), phenol or chemical destruction, and post-procedure care.
Plantar Fasciitis
Biomechanical assessment, palpation pattern, calf flexibility (Silfverskiöld), conservative-therapy trial documentation, orthotic prescription, and injection notes.
Wound Care
Ulcer measurement (length × width × depth in cm), tunneling and undermining, tissue type by percentage, periwound assessment, debridement extent, and dressing plan.
Sports Podiatry
Gait analysis, running mechanics, sport-specific footwear assessment, stress fracture and tendinopathy workup, return-to-play planning.
Surgical Foot/Ankle
Operative notes for hammertoe (CPT 28285), bunionectomy (28296), arthrodesis, and ankle arthroscopy with anesthesia, tourniquet time, and hardware capture.
Built for the foot exam, not retrofitted from primary care
Generalist ambient scribes treat podiatry as "exam findings." PatientNotes treats monofilament sites, ABI values, ulcer staging, and Q-modifier language as first-class outputs.
Diabetic foot exam capture
10-gram monofilament results captured site-by-site (1st, 3rd, 5th metatarsal heads, plantar hallux, plantar surface of toes — both feet), vibration with 128 Hz tuning fork, dorsalis pedis and posterior tibial pulses, ABI values with right and left, and skin integrity all documented in one pass.
Wagner and University of Texas ulcer staging
Ulcers automatically classified by Wagner grade (0-5) and University of Texas grade and stage (1A through 3D) based on depth, ischemia, and infection findings. Photo upload links to the staged ulcer record.
Medicare medical-necessity language
Routine foot care (nail and callus debridement) is only reimbursable with documented at-risk foot status and qualifying systemic disease. PatientNotes captures the Q7/Q8/Q9 class findings, vascular and neuropathy findings, and systemic-disease ICD pairing required for clean claims.
Procedure-note templates
Pre-built operative notes for hammertoe correction (CPT 28285), bunionectomy (28296), 1st MTP arthrodesis, ankle arthroscopy (29891), nail matrixectomy (11750), and orthotic dispensing — with anesthesia, tourniquet, hardware, and post-op orders.
Wound measurement tracking
Length, width, and depth in centimeters, plus tunneling, undermining, periwound condition, and tissue-type percentages (granulation, slough, eschar) tracked visit-over-visit so trajectory is visible.
EMA-friendly export
Notes paste cleanly into Modernizing Medicine's podiatry EMA, Athenahealth, eClinicalWorks, and Eclipse with HPI, exam, A&P, and procedure sections preserved — and Q-modifier reminders surface before claim submission.
A typical podiatry clinic morning
Podiatry has a documentation problem most other specialties don't — a huge fraction of clinic visits (routine nail and callus care) require very specific medical-necessity language to be reimbursable at all.
A normal four-hour podiatry clinic might run 18-22 patients: a couple of new diabetic foot evaluations, eight or nine routine nail and callus visits, two or three ulcer follow-ups with debridement, a sports biomechanics consult, an ingrown toenail with planned matrixectomy, a hammertoe pre-op, and a couple of custom orthotic dispensings. Most of these involve a procedure billed alongside the E/M, with modifier -25, and most of the routine nail and callus care needs Q7, Q8, or Q9 class findings documented or Medicare denies the claim.
The pain isn't the HPI or the assessment. It's the at-risk-foot language: documenting the Class A findings (loss of protective sensation, absent posterior tibial pulse, advanced trophic changes) that make a 64-year-old diabetic's nail debridement billable. Most DPMs write this paragraph 15-20 times a day. With a generalist scribe like Heidi or Freed, you still have to type or paste it. With Dragon you have a voice macro you have to remember to invoke.
PatientNotes handles it from the encounter audio. When you do the monofilament exam and call out the insensate sites, when you palpate the pulses and dictate the result, when you note the dystrophic nails and callus pattern, the at-risk findings land in the note with the correct Q-class flag and the systemic-disease + qualifying-finding pairing Medicare requires. The result, last updated April 2026, is that Q-modifier denials drop sharply for practices that switch over — and the time to close a routine foot care chart drops from about 4-5 minutes to under a minute.
Sample AI-generated diabetic foot exam
A 64-year-old type 2 diabetic with a new plantar hallux ulcer — full vascular, neuro, and dermatologic exam, Wagner staging, and Q7-supported routine foot care.
PATIENT: 64-year-old male DATE OF SERVICE: 04/12/2026 PROVIDER: PatientNotes Clinical Team CHIEF COMPLAINT: Diabetic foot exam - annual comprehensive evaluation. Patient also reports new ulceration on plantar right great toe, present approximately 3 weeks. HISTORY OF PRESENT ILLNESS: Established patient with type 2 diabetes mellitus (15-year history, last A1c 8.4% three weeks ago) presenting for annual diabetic foot exam. Reports a small open lesion on the plantar surface of the right hallux that he noticed about 3 weeks ago after walking barefoot. No drainage initially, now occasional clear yellow discharge. Denies fever, chills, or systemic symptoms. Reports decreased sensation in both feet, occasional burning at night controlled with gabapentin 300 mg PO TID. No claudication. Last lower extremity arterial study 2 years ago showed mild PAD bilaterally. PAST MEDICAL HISTORY: Type 2 DM, HTN, HLD, mild PAD ALLERGIES: NKDA MEDICATIONS: Metformin 1000 mg BID, lisinopril 20 mg daily, atorvastatin 40 mg daily, gabapentin 300 mg TID, aspirin 81 mg daily PHYSICAL EXAM: Vitals: BP 138/82, HR 78, T 98.4 F, BMI 31 General: Well-appearing, no acute distress, ambulating without assistance. FOOT EXAM (BILATERAL): Vascular: - Dorsalis pedis pulses: Right 1+ (diminished), Left 2+ (normal) - Posterior tibial pulses: Right 1+ (diminished), Left 2+ (normal) - Capillary refill: Right toes 4 seconds (delayed), Left toes 2 seconds (normal) - ABI today: Right 0.78 (mild PAD), Left 0.92 (within normal limits) - Hair growth: Diminished bilaterally, more on right - Skin temperature: Cool bilaterally, right slightly cooler than left Neurologic: - 10-gram Semmes-Weinstein monofilament (10 sites per foot): Right: insensate at plantar hallux, 1st MT head, 3rd MT head, 5th MT head; sensate at heel and dorsum (4/10 sites sensate) Left: insensate at 1st MT head, 5th MT head; sensate at remaining 8/10 sites - 128 Hz tuning fork vibration: Diminished bilaterally, absent at right hallux - Deep tendon reflexes: Achilles 1+ bilaterally (diminished) - Findings consistent with bilateral peripheral neuropathy, more advanced on the right Dermatologic: - Skin: Dry, scaly bilateral feet, mild interdigital tinea between 4th-5th toes bilaterally - Nails: 1st, 2nd, and 5th toenails right foot dystrophic, thickened, yellow discoloration consistent with onychomycosis - Plantar callus: 4 mm IPK at 1st MT head right, 3 mm callus at 5th MT head bilateral - Right hallux plantar surface: 0.8 cm × 0.6 cm × 0.2 cm depth ulceration, granulation tissue 70%, slough 30%, no undermining or tunneling, scant serous drainage, no surrounding erythema or fluctuance Musculoskeletal: - Hallux valgus right (15-degree angle), hallux limitus left - Hammertoe deformity 2nd toe right, semi-flexible - Equinus contracture bilateral (positive Silfverskiöld with knee extended) ULCER STAGING: - Wagner Grade 1 (superficial ulcer, no infection or ischemia involvement) - University of Texas Grade 1A (superficial wound, no infection, no ischemia) - At-risk foot status: YES (Q7 - one Class A finding [diabetic neuropathy with loss of protective sensation]) ASSESSMENT: 1. Type 2 diabetes mellitus with peripheral neuropathy and foot ulcer (E11.621, E11.40) 2. Diabetic foot ulcer right hallux, Wagner Grade 1 / UT Grade 1A (L97.511) 3. Mild peripheral arterial disease right > left, ABI 0.78 right (I70.213) 4. Onychomycosis of toenails right foot (B35.1) 5. Plantar callus, 1st and 5th MT head bilateral (L84) 6. Hammertoe right 2nd digit (M20.41) 7. Hallux valgus right (M20.11) 8. Equinus contracture bilateral (M24.575) PLAN: 1. Wound care: Debride plantar hallux ulcer, irrigate with normal saline, apply collagen dressing with foam cover. Patient educated on offloading with post-op shoe today; will bring custom diabetic insoles next visit. Daily dressing changes, return in 1 week for re-evaluation. 2. Routine foot care today (CPT 11721 - debridement of 6 or more dystrophic nails right foot; 11056 - paring of 2-4 hyperkeratotic lesions). Q7 modifier supported by Class A finding (LOPS - loss of protective sensation). 3. Topical antifungal (efinaconazole 10% solution) for onychomycosis right toenails, daily for 48 weeks. 4. Topical clotrimazole 1% cream for tinea pedis, BID for 2 weeks. 5. Refer to vascular surgery for ABI 0.78 and revascularization assessment given new ulceration. 6. Referral for custom diabetic accommodative insoles (A5500), Medicare-covered annually given LOPS and history of plantar callus. 7. Continue gabapentin 300 mg TID; reinforce daily foot inspection, no barefoot walking, and proper shoe fit. 8. PCP follow-up for A1c management; recommend tighter glycemic control given new ulcer. 9. Return in 1 week for ulcer reassessment, sooner for any sign of infection (increased erythema, fluctuance, warmth, drainage, or systemic symptoms). ICD-10: E11.621, E11.40, L97.511, I70.213, B35.1, L84, M20.41, M20.11 CPT: 11721, 11056, 99214 (E/M with separately identifiable service, modifier -25)
Common podiatry ICD-10 codes, suggested automatically
The AI suggests both ICD-10 and CPT directly from the documentation. Common pairings include 99214 + E11.621 + 11721 (with Q7 modifier) for diabetic nail debridement, 99213 + L60.0 + 11750 for ingrown toenail with matrixectomy, and 99213 + M72.2 for plantar fasciitis.
E11.621Type 2 diabetes mellitus with foot ulcerL97.521Non-pressure chronic ulcer of left foot, limited to skin breakdownM20.40Other hammer toe(s), unspecified footM72.2Plantar fascial fibromatosis (plantar fasciitis)L60.0Ingrowing nailL84Corns and callositiesM21.6X1Other acquired deformities of right footE11.40Type 2 diabetes mellitus with diabetic neuropathyCommon procedure codes: 11055-11057 (callus debridement), 11719 (non-dystrophic nail debridement), 11720 and 11721 (dystrophic nail debridement, 1-5 and 6+), 11750 (matrixectomy), 28285 (hammertoe), 28296 (bunionectomy). Q7/Q8/Q9 modifiers are auto-flagged when at-risk findings are documented.
How podiatrists actually use it
Three working DPMs across solo, group, and hospital settings. The common thread is medical-necessity language for routine foot care — that's where the time and the money are.
Dr. T. Hassan, DPM
Solo podiatrist, urban diabetic foot focus, 90% Medicare panel
Routine nail and callus debridement was the documentation bottleneck — every visit needed at-risk foot status, Q-modifier justification, and the systemic-disease + physical-finding pairing for Medicare to pay. Was rewriting that paragraph 25 times a day. PatientNotes captures the monofilament, pulses, and Q-class findings from the encounter audio and produces audit-defensible note language. Q-modifier denials dropped from about three per week to nearly zero. Net cost: $600/year, vs roughly $1,200 in lost revenue from denials in a typical month before.
Cascade Foot & Ankle, 5 DPMs
Group practice with surgical and orthotic focus
Group was on Heidi Health at $99/month per provider ($5,940/year) and happy with general note quality, but spent admin time correcting Q-modifier and ulcer-staging language before claim submission. Pilot found PatientNotes captured Wagner staging and at-risk findings without manual fixup. Switched the practice over at $3,000/year — a $2,940 saving plus less admin rework. Kept Heidi for office staff brief notes only.
Dr. R. Whitfield, DPM
Hospital-employed surgical podiatrist, 700-bed academic system
Operative notes for hammertoe correction, Lapidus, and triple arthrodesis were taking 12-15 minutes each because of hardware tracking, tourniquet time, and dictating the post-op orders that had to land in Epic. PatientNotes' surgical templates fill in anesthesia, tourniquet, hardware, and post-op orders from the operating-room audio. Average operative-note documentation time fell to under 5 minutes. Hospital still uses Dragon for a few legacy templates.
Coming from Dragon Medical One?
Dragon is the dictation default for many podiatrists, especially those affiliated with a hospital. It is fast and accurate at transcription. The case for trying PatientNotes is not that Dragon is bad — it is that ambient capture changes the math for podiatry specifically.
The podiatry-specific argument for ambient AI is the at-risk-foot paragraph. With Dragon you either dictate the same medical-necessity language 15-20 times a day or you build a voice macro you have to remember to invoke (and update when CMS changes the criteria). With PatientNotes, when you do the monofilament and pulse exam aloud — which is the default workflow for any DPM — the Q-class findings land in the note automatically.
How to switch (or run side-by-side)
- Day one: Create an account and import three of your most-used templates — a typical diabetic foot exam, a routine nail-and-callus visit, and a post-op follow-up. Section order, default negatives, Q-modifier prompts, and signature block all configure per provider.
- Week one: Run PatientNotes on a single half-day clinic. Compare three or four notes side-by-side with what Dragon produces. Most DPMs are convinced by the Q-modifier capture alone within ten visits.
- Week two onward: Move all routine office visits over. Keep Dragon for OR dictation if your hospital affiliation requires it. Solo and group podiatrists typically retire Dragon entirely within three to four weeks.
Detailed feature-by-feature comparison lives at /compare/dragon-medical-one.
PatientNotes vs Heidi Health for podiatry
Heidi is the most common ambient scribe podiatrists actually try first because of its generous free tier. Here is the honest side-by-side once you cross from free into paid.
Honest summary: Heidi is genuinely good as a generalist note writer and the free tier is a reasonable starting point. The friction shows up in podiatry-specific places — Wagner staging, Q-modifier language, monofilament site capture, and operative templates for hammertoe and bunion correction. For a busy DPM panel where 60-70% of visits hinge on Medicare medical-necessity documentation, those gaps matter more than the price difference.
Detailed breakdown: /compare/heidi-health.
Frequently asked questions
Last updated April 2026 by the PatientNotes Clinical Team.
Does PatientNotes work for podiatry?
Yes. It captures the focused podiatric exam — vascular (DP and PT pulses, ABI), neurologic (10-gram monofilament at 10 sites, 128 Hz vibration, DTRs), and dermatologic (skin, nails, ulcer staging by Wagner or University of Texas). Procedure notes for nail and callus debridement, hammertoe correction, bunionectomy, ankle arthroscopy, and matrixectomy are pre-templated.
How much does an AI scribe cost for podiatry?
PatientNotes is $50 per podiatrist per month, or $600 per year. Heidi Health is typically $99 per month per provider after the free tier ($1,188 per year), and generalist enterprise scribes like Suki and DAX run $200-300 per month. For a three-DPM practice, PatientNotes is $1,800 per year vs roughly $3,564 on Heidi or $7,200-$10,800 on DAX.
Is Heidi better than PatientNotes for podiatry?
Heidi is a strong generalist scribe with a generous free tier. Where PatientNotes wins for podiatry is depth on the foot exam — automatic capture of monofilament results by site, ABI values with right and left, Wagner ulcer staging, and the medical-necessity language (Q-modifiers, at-risk foot status) that controls Medicare reimbursement for routine nail and callus care. Heidi will write a note. PatientNotes writes the audit-defensible note.
Can podiatry-specific notes be auto-generated?
Yes. Pre-built templates exist for the comprehensive diabetic foot exam, ingrown toenail (matrixectomy), plantar fasciitis with biomechanical assessment, Charcot foot staging, wound care follow-up with measurements, sports podiatry biomechanical evaluation, and operative notes for hammertoe (CPT 28285), bunionectomy (28296), and ankle arthroscopy (29891). Custom orthotic prescriptions and DME documentation are pre-formatted.
Does it integrate with Modernizing Medicine, Athenahealth, or Eclipse?
PatientNotes works as a paste-ready scribe today with Modernizing Medicine's podiatry EMA module, Athenahealth, eClinicalWorks, and the Eclipse podiatry-specific EMR — notes export with preserved structure into HPI, exam, A&P, and procedure fields. ModMed EMA is the most common podiatry-specific EMR; PatientNotes drops into its template fields cleanly. Native HL7/FHIR write-back is on the 2026 roadmap.
Will it help me bill podiatry-specific CPT codes correctly?
PatientNotes suggests podiatry CPT codes from the documentation — 11055-11057 for callus debridement, 11719 for non-dystrophic and 11720-11721 for dystrophic nail debridement, 11750 for matrixectomy, 28285 for hammertoe correction, 28296 for bunionectomy. It flags Q7/Q8/Q9 class findings (at-risk foot) required for Medicare coverage of routine foot care, and prompts for the systemic disease + qualifying physical finding documentation that makes 11720 reimbursable.
How do I switch from Dragon Medical One to PatientNotes?
Most podiatrists pilot both for two weeks. Step one: create an account and import three templates (a diabetic foot exam, a routine nail-and-callus visit, a post-op follow-up). Step two: run PatientNotes on a single half-day clinic and compare. Step three: switch routine office visits over — almost all DPM clinic time. Many podiatrists drop Dragon entirely within three to four weeks; the only common holdout is OR dictation.
Is it HIPAA compliant for podiatry?
Yes. PatientNotes is HIPAA-compliant, signs a Business Associate Agreement (BAA), encrypts data in transit and at rest, and stores PHI in US-based data centers. Audio is processed in-region, never used to train external models, and can auto-purge after note generation. Wound care and diabetic foot photographs uploaded with notes are encrypted and stored separately from the audio stream.
Related specialty pages
See more feet. Skip the medical-necessity rewrites.
Q-modifier denials are the single biggest hidden cost in podiatry. PatientNotes captures the at-risk-foot findings that make routine care reimbursable — automatically, from the encounter audio.
No credit card required. $50/month after trial. Cancel any time.