<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".04" citation="COMAR 10.09.15.04" title_num="10" subtitle_num="09" chapter_num="15" heading="Covered Services">
  <text>The Program covers the following medically necessary services:</text>
  <paragraph num="A.">
    <text>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:</text>
    <paragraph num="(1)">
      <text>Performed by the podiatrist or another licensed podiatrist in the podiatrist’s employ;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Performed on the:</text>
      <paragraph num="(a)">
        <text>Human foot or ankle;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Anatomical structures that attach to the human foot; or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Soft tissue below the midcalf;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Clearly related to the participant’s individual medical needs as diagnostic, curative, palliative, or rehabilitative services; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Adequately described on the participant’s medical record.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>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:</text>
    <paragraph num="(1)">
      <text>Arteriosclerosis obliterans (A.S.O., arteriosclerosis of the extremities, occlusive peripheral arteriosclerosis);</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Buerger’s disease (thromboangiitis obliterans);</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Peripheral neuropathies involving the feet, associated with:</text>
      <paragraph num="(a)">
        <text>Traumatic injury;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Leprosy or neurosyphilis; or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Hereditary disorders, such as hereditary sensory radicular neuropathy, angiokeratoma corporis diffusum (Fabry’s) and amyloid neuropathy; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>The following conditions, if the patient is under the active care of a doctor of medicine or osteopathy who documents the condition:</text>
      <paragraph num="(a)">
        <text>Diabetes mellitus;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Chronic thrombophlebitis;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Peripheral neuropathies involving the feet, associated with:</text>
        <paragraph num="(i)">
          <text>Malnutrition and vitamin deficiency such as malnutrition (general and pellagra), alcoholism, malabsorption (celiac disease and tropical sprue), and pernicious anemia;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Carcinoma;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Diabetes mellitus;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Drugs and toxins;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Multiple sclerosis; or</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>Uremia (chronic renal disease).</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Drugs dispensed by the podiatrist in an emergency or drugs which cannot be self-administered within the limitations of COMAR 10.09.03;</text>
  </paragraph>
  <paragraph num="D.">
    <text>Injectable drugs administered by the podiatrist within the limitations of COMAR 10.09.03;</text>
  </paragraph>
  <paragraph num="E.">
    <text>Medical equipment and supplies prescribed by the podiatrist within the limitations of COMAR 10.09.12; and</text>
  </paragraph>
  <paragraph num="F.">
    <text>Emergency services and related follow-up care.</text>
  </paragraph>
</regulation>