CommercialCoverageMedium impact
Evaluation and Management (E&M) of Diabetic Peripheral Neuropathy with Loss of Protective Sensation (LOPS)
Independence Blue Cross·PA · Endocrinology, Podiatry, Family Medicine +1 more·Medical Policy
Effective date
Jun 29, 2026
We identified it
Jun 16, 2026
Summary
Policy for E&M of diabetic peripheral neuropathy with LOPS will be archived effective June 29, 2026, as the service is now considered standard of care. Codes G0245 and G0246 are not separately reimbursable when billed with E&M, consultation, or routine foot care codes.
Action Required
By June 29, 2026: Billing team must update system rules to prevent separate billing of G0245 and G0246 when submitted with E&M codes, consultation codes, or routine foot care codes. Ensure documentation includes required elements: patient history, visual foot inspection, protective sensation evaluation, foot structure assessment, vascular status evaluation, and patient education for all diabetic neuropathy visits.