Sorry I meant to post these responses a few months ago.
ORIGINAL POST
Hi Listserve members,
Does a there exist a Medicare-approved list of what a DPM may or may not
prescribe in the orthotics/prosthetics arena? Randy McFarland, CPO
RESPONSES
In Chapter 3 of the Suppliers Manual, services ordered by podiatrists is
addressed. It is contingent upon the scope of practice statutes of the state
you are in. The manual states in part the following:
Medicare coverage for all items and services furnished or ordered by
podiatrists is limited by State statutes governing the scope of practice for
podiatry. DMEPOS suppliers should be familiar with the limitations imposed
by the statutes of the state(s) in which they operate and dispense DMEPOS
items. Claims submitted to the DME MAC, when furnished or ordered by
podiatrists practicing outside the limits of their licensures, will be
denied as statutorily noncovered. Podiatrists are excluded by statute from
ordering a power operated vehicle (POV) or power wheelchair.
In my practice our rule is we accept an order for a DPM on Custom FO’s (non
diabetic) and any orthosis below the tendoachilles junction. In effect any
brace a pedorthist can make minus diabetic goods. A Do or Md for all else.
Of course the only exception to all this is the VA. Hope this helps.
I don’t know of a specific list. But any Afo, Arizona. Richie brace ptb.
Rule of thumb is their scope is from the knee down. So they can prescribe
anything from the ken. Down. Partial foot prostheses as well toe fillers
Symes prostheses. Etc.
Medicare does not determine what a Podiatrist can prescribe. Podiatrists
can only prescribe things within the scope of their practice, each State
licensing board determines the scope of DPM practice. You would have to
review scope of practice for your state.
