Podiatry Coding & Billing Alert

Question: How often can we bill Medicare for an evaluation of the feet? Is the exam only covered for certain diagnoses? Wisconsin Subscriber Answer: Medicare covers an evaluation (examination and treatment) of the feet no more than every six months for individuals with a documented diagnosis of diabetic sensory neuropathy (250.60, 337.1) with loss of protective sensation (LOPS), as long as the beneficiary has not seen a foot care specialist for some other reason in the interim.This is known as the bi-annual exam. For a new patient, you would report G0245 (Initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation [LOPS] which must include [1]  the diagnosis of LOPS, [2] a patient history, [3] a physical examination that consists of at least the following elements: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of [...]