I work in internal medicine and we have a very high diabetic population on Medicare/MA plans. We are on Noridian Medicare. We have been trying to use the diabetic foot codes (G0245, G0246, G0247) They seem to be getting paid only intermittently and very rarely from Medicare. I can't figure out what I am doing wrong. On the other hand is anyone having any success using the corn removal codes getting paid by Medicare/ MA plans?
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Wiki Diabetic Foot Codes
- Thread starter mrsjehu
- Start date
dclark7
True Blue
Have you been following the CMS guidelines for G0245, G0246, G0247. According to the Claims Processing Manual 100-04, Chapter 32, Section 80 these code are paid every 6 months and only if the beneficiary has not seen a foot care specialist for some other reason in the interim. Also, once the condition has progressed to a point where routine foot care is a covered benefit these codes are no longer payable.
Corn removal is a non-covered service except for patients with systemic disease who meet certain criteria.
Corn removal is a non-covered service except for patients with systemic disease who meet certain criteria.
I had not been following those codes. New to internal medicine and trying to figure all this out! Thank you for the reference on the diabetic foot codes.
Where can I find the info on the corn removal?
Our patient's who are having foot care done by our doctor their feet are quite bad and they have not had this done within 6months elsewhere. Still, we are getting various denials.
Where can I find the info on the corn removal?
Our patient's who are having foot care done by our doctor their feet are quite bad and they have not had this done within 6months elsewhere. Still, we are getting various denials.
dclark7
True Blue
Not sure if Noridian has an LCD for Routine Foot Care, but here's the link to NGS' LCD (L26426) which will give you the information that CMS is looking for. http://www.cms.gov/medicare-coverage-database/details/lcd-details.aspx?LCDId=26426&ContrId=299&ver=63&ContrVer=1&CntrctrSelected=299*1&Cntrctr=299&name=National+Government+Services%2c+Inc.+(National+Government+Services%2c+Inc.+(13102%2c+A+and+B+and+HHH+MA