02/07/2017

Correct Usage and Billing of G9226

CAN YOU TELL ME IF ANYONE OUT THERE BILLS CPT CODE G9226 (DIABETIC FOOT EVALUATION) AND IF SO WHAT THE FEE FOR THIS CODE SHOULD BE?

G9226 is a PQRS measure (diabetic foot exam), this is not a service that is paid by FFS Medicare or any other insurance. This code should only be billed if a physician is completing a comprehensive diabetic foot examination in conjunction with an office visit as part of the reporting requirements with MIPS (formerly PQRI/PQRS). If billed, the code should be billed for $0.01 (or another nominal amount) for reporting purposes only to the insurance.