CMS and Diabetic Verification Form and Physician Documentation Requirements

CMS and Diabetic Verification Form and Physician Documentation Requirements

Brett R. Saunders, CPO, FAAOP

3/8/2013

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