Podiatry Coding & Billing Alert

In general, Loss of Protective Sensation (LOPS) occurs when an individual is unable to sense or feel a minor injury or trauma that can occur from a variety of sources -- for example, if a patient unknowingly steps on an sharp or penetrating object, hits or scrapes his foot or lower extremity on an object, or even sustains a thermal injury from a heating pad or close proximity to a floor or space heater.

Result: A patient with LOPS can develop a blister on the foot from wearing a shoe that is too tight or too loose. A corn or callous problem can cause an ulceration to develop beneath it due to the pressure placed on the underlying skin below.

Bottom line: Whether there is a partial or complete loss of sensation or feeling, it will affect the patient's ability to feel pain in the foot and possibly the lower leg as well. Therefore, the patient is at a greater risk of developing complications such as open wounds, ulcerations, and infections due to a lack of sensation should he sustain some form of minor trauma. Injuries to the foot that create an open wound, if not promptly detected and treated, could lead to complications, including infection to the soft tissues and bone. This could eventually lead to amputation in some cases.

Because of these known risks, certain routine foot care procedures, including debridement and/or trimming of nails, corns, and calluses (Routine Foot Care), is a covered service and considered medically necessary when supported by documentation in the medical record, says Richard D. Odom, DPM, CPC, a podiatrist in Spanish Fort, Ala.