Re: custom footware for non-diabetic patient

[Guest guest]

If the person has peripheral neuropathy and/or marked " deformities " of the foot,

i.e. amputation or other diagnoses, they should be able to bill Medicare. It

has to be thoroughly described as to the medical necessity either by a PT or

orthotist. MD signature would also be a must and documentation in the physician

notes backing up your medical necessity would be helpful. Good Luck. Sue

Whitney PT

________________________________

To: PTManager

Sent: Sat, June 19, 2010 12:16:18 PM

Subject: custom footware for non-diabetic patient

Does Medicare pay for custom molded shoes for non-diabetic patients?

I have a young adult medicare patient with a rare familial condition, who

presents with a huge foot with what appears to be a plantar cerebriform

connective-tissue nevus encompassing the whole plantar surface, a distant

history of toe amputation due to a non-healing ulcer, a current stage 1-2

pressure wound. The patient is non-ambulatory, but uses both feet for

wheelchair propulsion and transfers. It is impossible for this person to fit

into a normal pair of shoes without having pressure issues. The consulting

orthotist states that Medicare will not pay for custom footware for non-diabetic

patients, yet this seems to be the only reasonable solution for this person.

Any suggestions?

Hansen, PT, PhD

Rehabilitation Institute of Kansas City

Kansas City, Missouri