Re: CMS and Diabetic Verification Form and Physician Documentation Requirements
Karl Entenmann
Description
Collection
Title:
Re: CMS and Diabetic Verification Form and Physician Documentation Requirements
Creator:
Karl Entenmann
Date:
3/9/2013
Text:
Hi Brett,
Another question we have is the one about peripheral neuropathy with evidence of callous formation. Is peripheral neuropathy alone enough for Medicare? Example would be someone with little or no sensation in the foot. Definitely a reason for diabetic shoes but is it enough for Medicare?
Karl Entenmann, CPO
Pref O & P
Sent from my iPad
On Mar 8, 2013, at 12:56 PM, Brett R. Saunders, CPO, FAAOP < <Email Address Redacted> > wrote:
> Concerning Medicare and coverage for diabetic shoes, is anyone aware of a specific reference as to what constitutes a 'foot deformity' under the Medicare/CMS guidelines? And, while asking…what is the minimum criteria or diagnoses for supporting a selection of 'poor circulation' on the diabetic verification form?
>
> While things like Charcot deformities, bunions, and hammer toes seem easy to identify, would heel spurs also be considered a foot deformity?
>
> There is debate in my office about the heel spur being considered a deformity.
>
> Specific notes commenting on reduced pulses and doppler test results seem rock solid, but would notes about swelling or edema (without mention of tests or pulses) in the legs and/or feet also meet the physician note support requirement for the selection of Poor Circulation?
>
> I will repost the consensus opinion and any reference material identified.
>
> Thank you,
>
> Brett
>
> Brett R. Saunders, CPO, FAAOP
> <Email Address Redacted>
> 761 County Road 466
> Lady Lake, FL 32159
> (352) 259-9749 Phone
> (352) 259-8209 Fax
>
>
>
Another question we have is the one about peripheral neuropathy with evidence of callous formation. Is peripheral neuropathy alone enough for Medicare? Example would be someone with little or no sensation in the foot. Definitely a reason for diabetic shoes but is it enough for Medicare?
Karl Entenmann, CPO
Pref O & P
Sent from my iPad
On Mar 8, 2013, at 12:56 PM, Brett R. Saunders, CPO, FAAOP < <Email Address Redacted> > wrote:
> Concerning Medicare and coverage for diabetic shoes, is anyone aware of a specific reference as to what constitutes a 'foot deformity' under the Medicare/CMS guidelines? And, while asking…what is the minimum criteria or diagnoses for supporting a selection of 'poor circulation' on the diabetic verification form?
>
> While things like Charcot deformities, bunions, and hammer toes seem easy to identify, would heel spurs also be considered a foot deformity?
>
> There is debate in my office about the heel spur being considered a deformity.
>
> Specific notes commenting on reduced pulses and doppler test results seem rock solid, but would notes about swelling or edema (without mention of tests or pulses) in the legs and/or feet also meet the physician note support requirement for the selection of Poor Circulation?
>
> I will repost the consensus opinion and any reference material identified.
>
> Thank you,
>
> Brett
>
> Brett R. Saunders, CPO, FAAOP
> <Email Address Redacted>
> 761 County Road 466
> Lady Lake, FL 32159
> (352) 259-9749 Phone
> (352) 259-8209 Fax
>
>
>
Citation
Karl Entenmann, “Re: CMS and Diabetic Verification Form and Physician Documentation Requirements,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 6, 2024, https://library.drfop.org/items/show/234803.
