02/02/2017
Rules for Diabetic Shoes and Inserts for 2017
I would like clarification of Rules for Diabetic Shoes and Inserts for 2017: A patient scheduled CDFE Comprehensive Diabetic Foot Exam in November 2016 and decided she wants diabetic shoes and inserts in January of 2017. Can the 2016 exam be sent with the 2 page form for Diabetic shoes to the Physician for dispensing of shoes and inserts in January of 2017? Are Diabetic shoes and inserts dispensing for a fiscal year or for 1 year from the date of the CDFE? Thank you
The coverage of diabetic shoes is limited to one pair of shoes and 3 sets of inserts within one calendar year (Jan-Dec), if the patient meets the medical necessity criteria outlined in the LCD policy and the policy article from Noridian Medicare services.
The CDFE, along with other supporting documentation from the supplying physician and the PCP/rendering physician, can be used as long as the documentation is within six months from the date the diabetic shoes were dispensed to the patient. An exam in November 2016 for shoes that would be dispensed in January 2017 would be acceptable.
Please see LCD policy for Therapeutic Shoes for Persons with Diabetes (L33369) below:
http://nyspma.org/aws/NYSPMA/asset_manager/get_file/145952?ver=1194
Below is the link to the Policy Article: