Question 1

What is HCPCS code G0245?

Accepted Answer

HCPCS code G0245 is "Initial foot exam pt lops". 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 a 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 (4) patient education

Question 2

What category is G0245 in?

Accepted Answer

G0245 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0245?

Accepted Answer

Use G0245 when billing for initial foot exam pt lops. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is G0245 covered by Medicare?

Accepted Answer

Coverage for G0245 (Initial foot exam pt lops) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for G0245?

Accepted Answer

Documentation for G0245 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).