# COMAR Title 10 — Maryland Department of Health

## Subtitle 09 — Medical Care Programs

### Chapter 15 — Podiatry Services

#### Regulation .04 Covered Services

*COMAR 10.09.15.04*

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.