2015年10月1日 · Inserts and modifications used with L-coded footwear must be coded using L codes (refer to the Orthopedic Footwear LCD and LCD-related Policy Article for more information). Inserts for missing toes or partial foot amputation should be coded L5000 or L5999, whichever is applicable.

2015年10月1日 · The purpose of a Local Coverage Determination (LCD) is to provide information regarding “reasonable and necessary” criteria based on Social Security Act § 1862 (a) (1) (A) provisions. The LCD-related Standard Documentation Requirements Article, located at the bottom of this policy under the Related Local Coverage Documents section.

2025年3月12日 · PDAC Coding Guidelines for Off-the-Shelf Diabetic Shoes (A5500) - The information presented in this article comes from the Therapeutic Shoes for Persons with Diabetes Local Coverage Determination (L33369) and related Policy Article (A52501), coding language, coding guidelines, and assessment of samples that have been submitted to the PDAC for ...

2021年11月2日 · • LCA: Therapeutic Shoes for Persons with Diabetes – Policy Article (A52501) For orthopedic footwear used with a leg brace, both the leg brace and the footwear must be billed by the same supplier.

2017年1月1日 · All claims for items billed to Medicare require a written order/prescription from the treating practitioner as a condition for payment. This written order/prescription is referred to as the Standard Written Order (SWO) (see below). “All claims” refers to all claims submitted for payment of purchases or rentals to Medicare Part B.

To provide suppliers with in-depth insight into LCD requirements via claim examples and real life scenarios, Noridian will begin hosting policy specific L200 webinars. Fax claim examples to 701-433-5957

2021年7月20日 · For custom molded shoes (A5501) and inserts (A5513), taking impressions, making casts, or obtaining CAD-CAM images of the beneficiary’s feet. Criterion 5: An objective in-person evaluation at the time of delivery including the following: Assessment with the beneficiary wearing the shoes and inserts: and.

A52501-Therapeutic Shoes for Persons with Diabetes - Policy Article. A55426-Standard Documentation Requirements for All Claims Submitted to DME MACs ... 17013. Contractor Type: DME MAC. LCD Information: LCD ID Number: L33369 Status: A-Approved . LCD Title: Therapeutic Shoes for Persons with Diabetes. Geographic Jurisdiction: Illinois, Indiana ...

Therapeutic Shoes and inserts are covered under the Therapeutic Shoes for Individuals with Diabetes benefit (Social Security Act §1861(s)(12)). In order for a beneficiary’s equipment to be eligible for reimbursement the reasonable and necessary (R&N) requirements set out in the related Local Coverage Determination must be met.

LCD - Therapeutic Shoes for Persons with Diabetes (L33369) (cms.gov) Routine review, codes updated, reference added related to expanded ability for NP/PA’s to certify medical need for diabetic shoes through “incident to” provisions.