Regulation .04 Covered Services
Regulation .04 Covered ServicesLinkCopy Citation
The Program covers the following medically necessary services:
A.
Podiatric services rendered in the podiatrist's office, the participant's home, a hospital, a nursing facility, a free standing clinic, or elsewhere when these services are:
(1)
Performed by the podiatrist or another licensed podiatrist in the podiatrist’s employ;
(2)
Performed on the:
(a)
Human foot or ankle;
(b)
Anatomical structures that attach to the human foot; or
(c)
Soft tissue below the midcalf;
(3)
Clearly related to the participant’s individual medical needs as diagnostic, curative, palliative, or rehabilitative services; and
(4)
Adequately described on the participant’s medical record.
B.
Routine podiatric care rendered in an office, home, nursing home, or licensed assisted living facility for participants who have a metabolic, neurologic, or vascular disease affecting the lower extremities, including but not limited to:
(1)
Arteriosclerosis obliterans (A.S.O., arteriosclerosis of the extremities, occlusive peripheral arteriosclerosis);
(2)
Buerger’s disease (thromboangiitis obliterans);
(3)
Peripheral neuropathies involving the feet, associated with:
(a)
Traumatic injury;
(b)
Leprosy or neurosyphilis; or
(c)
Hereditary disorders, such as hereditary sensory radicular neuropathy, angiokeratoma corporis diffusum (Fabry’s) and amyloid neuropathy; and
(4)
The following conditions, if the patient is under the active care of a doctor of medicine or osteopathy who documents the condition:
(a)
Diabetes mellitus;
(b)
Chronic thrombophlebitis;
(c)
Peripheral neuropathies involving the feet, associated with:
(i)
Malnutrition and vitamin deficiency such as malnutrition (general and pellagra), alcoholism, malabsorption (celiac disease and tropical sprue), and pernicious anemia;
(ii)
Carcinoma;
(iii)
Diabetes mellitus;
(iv)
Drugs and toxins;
(v)
Multiple sclerosis; or
(vi)
Uremia (chronic renal disease).
C.
Drugs dispensed by the podiatrist in an emergency or drugs which cannot be self-administered within the limitations of COMAR 10.09.03;
D.
Injectable drugs administered by the podiatrist within the limitations of COMAR 10.09.03;
E.
Medical equipment and supplies prescribed by the podiatrist within the limitations of COMAR 10.09.12; and
F.
Emergency services and related follow-up care.