G0246
ActiveFollowup eval of foot pt lop
Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following: (1) a patient history, (2) a physical examination that includes: (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, and (e) evaluation and recommendation of footwear, and (3) patient education
MUE — Medically Unlikely Edits
Maximum units of G0246 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.
| Service Type | Max Units / Day |
|---|---|
| Outpatient Hospital | 1 |
| Practitioner Services | 1 |
Source: CMS Medicare NCCI Medically Unlikely Edits
NCCI Edits
The following codes cannot be billed together with G0246 without appropriate documentation.
| Column 2 Code | Modifier |
|---|---|
| G0127 | Modifier cannot bypass edit |
Source: CMS National Correct Coding Initiative (NCCI)
NCCI Edits — Reverse Direction
G0246 cannot be billed together with the following column 1 codes without appropriate documentation.
| Column 1 Code | Modifier |
|---|---|
| G0245 | Modifier cannot bypass edit |
| G0337 | Modifier cannot bypass edit |
| G0380 | Modifier may bypass edit |
| G0381 | Modifier may bypass edit |
| G0382 | Modifier may bypass edit |
| G0383 | Modifier may bypass edit |
| G0384 | Modifier may bypass edit |
| G0463 | Modifier cannot bypass edit |
Source: CMS National Correct Coding Initiative (NCCI)