Payment will be approved only for certain podiatric
services.
(1) Payment will be approved
for the following orthotic appliances and treatment of nail pathologies:
a. Durable plantar foot orthotic.
b. Plaster impressions for foot
orthotic.
c. Molded digital
orthotic.
d. Shoe padding when
appliances are not practical.
e.
Custom molded space shoes for rheumatoid arthritis, congenital defects and
deformities, neurotropic, diabetic and ischemic intractable ulcerations and
deformities due to injuries.
f.
Rams horn (hypertrophic) nails.
g.
Onychomycosis (mycotic) nails.
(2) Payment will be made for the same scope
of podiatric services available through Part B of Title XVIII (Medicare) except
as listed below:
a. Treatment of flatfoot.
The term "flatfoot" is defined as a condition in which one or more arches have
flattened out.
b. Treatment of
subluxations of the foot are defined as partial dislocations or displacements
of joint surfaces, tendons, ligaments, or muscles of the foot. Surgical or
nonsurgical treatments undertaken for the sole purpose of correcting a
subluxated structure in the foot as an isolated entity are not covered.
Reasonable and necessary diagnosis of symptomatic conditions
that result from or are associated with partial displacement of foot structures
is a covered service. Surgical correction in the subluxated foot structure that
is an integral part of the treatment of a foot injury or is undertaken to
improve the function of the foot or to alleviate an induced or associated
symptomatic condition is a covered service.
c. Routine foot care. Routine foot care
includes the cutting or removal of corns or callouses, the trimming of nails
and other hygienic and preventive maintenance care in the realm of self-care
such as cleaning and soaking the feet, the use of skin creams to maintain skin
tone of both ambulatory and bedfast patients and any services performed in the
absence of localized illness, injury, or symptoms involving the foot.
d. Orthopedic shoes. Payment will not be made
for orthopedic shoes or for any device to be worn in or attached to orthopedic
shoes or other types of shoes when provided by the podiatrist. Payment will be
made to the podiatrist for the examination including tests to establish the
need for orthopedic shoes.
(3) Prescriptions are required for drugs and
supplies as specified in paragraph 78.1(2)
"c." Payment shall
be made for drugs dispensed by a podiatrist only if there is no licensed retail
pharmacy in the community where the podiatrist's office is located. If eligible
to dispense drugs, the podiatrist should request a copy of the Prescribed Drugs
Manual from the Iowa Medicaid enterprise provider services unit. Payment will
not be made for writing prescriptions.
This rule is intended to implement Iowa Code section
249A.4.
