Wiki LOPS- G0245, G0246, G0247

[twalls]

Hi! Can someone talk to me billing for LOPS? I know the guidelines per CMS, but just recently tried sending out a couple to trial them and they came back as missing HCPS- I sent the G0246-25 G0247-Q8, DX E11.42, L60.3, with referring provider and date last seen as well.
-Does the podiatrist bill these?
- What if previously 11721, 11056 was billed 4 months prior with the same dx? Maybe I can't now switch to LOPS?

Not sure what I am doing with these! Help!

Thanks so much!

 

[podcoder70]

CMS regulations state that to be able to use these codes the patient cannot have been seen by a foot care specialist within 6 months. The Q modifier does not apply to these codes. You must code G0247 WITH either G0245 or G0246 for payment. If you are providing routine foot care for the patient, or another provider has been doing so, the G codes can no longer be used, these codes are included in the RFC codes 11055-7 and 11720-21 (to name a few)To use these G codes you must document the following:
G0245 & 6:
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 protective sensation

c. Evaluation of foot structure and biomechanics

d. Evaluation of vascular status and skin integrity

e. Evaluation and recommendation of footwear
4. Patient education

G0247 Routine Foot Care by a Physician for a diabetic patient with diabetic sensory neuropathy resulting in LOPS to include, the local care of superficial wounds (ie. superficial to muscle and fascia), and at least the following if present:

1. Local care of superficial wounds
2. Debridement of corns and calluses
3. Trimming and debridement of nails

I can't see that these codes could be used very often...