Billing and Coding: Routine Foot Care

Routine foot care is covered only when the patient has one or more ICD-10 diagnoses that meet medical necessity per LCD L33941 (including specific groups for peripheral neuropathy, anticoagulation, and complicating conditions requiring Q modifiers). Claims must include adequate, legible documentation supporting the ICD-10 and CPT/HCPCS codes, provider signatures, and when applicable the diagnosing provider name/date and specific findings (e.g., Class A/B/C signs or 5.07 monofilament results); services not meeting these criteria are noncovered and should be billed with modifier GY.

"Routine foot care is covered only when the patient has one or more diagnoses listed in the LCD L33941 “ICD-10 Codes that Support Medical Necessity."

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