WebRe: Diabetic Footwear Documentation Request Dear Dr. I am writing to request your assistance in providing the above patient with diabetic footwear, as provided under the … WebDIABETIC FOOTWEAR PRESCRIPTION FORM Patient: Date of Order: DOB: _ ____ HICN: 1 Pair 3 Pair . 3 Pair . A5500 A5512 . OR A5513 . Diabetic Depth Shoes, pair Prefabricated inserts pairs-multiple density, direct formed, molded to foot with external heat source (i.e. heat gun). Medicare allows three pairs of inserts per year.

Order and Return Forms Dr. Comfort

WebICD codes must clearly indicate one of the conditions listed below (please indicate which foot). Therapeutic shoes, inserts, and/or modifications to therapeutic shoes are covered if the following criteria are met: 1. Patient has diabetes mellitus (ICD diagnosis codes E08.00 through E13.9); AND 2. Patient has one or more of the following conditions. WebSM Diabetic Shoe Order Entry Form Enter orders at SafeStep.net Questions? Call 866.712.STEP (7837) '2012 SafeStep Rev. 101712 ... This patient requires diabetic shoes and heat-molded or custom-molded inserts to help prevent ulcers and further complications. '2012 SafeStep Rev. 101712 guy from what would you do

Training & Resources for Providers Dr. Comfort

WebA few beneficiaries self-reported that they did not have diabetes or other qualifying conditions. Almost half of the beneficiaries receiving custom-molded shoes denied having the requisite foot deformity. Some beneficiaries report problems with the footwear. Thirteen percent of beneficiaries reported seldom or never wearing the shoes. Most did not WebMedical records of diabetes management (not older than 6 months and signed/co signed by MD or DO) Documents required for fitting/ delivery of diabetic shoes: D Checklist for initial fitting of diabetic shoes Final fitting for diabetic shoes Follow-up for diabetic shoes (completed at one week] http://thefittingplace.com/wp-content/uploads/2024/04/medicare-forms-for-diabetic-shoes2.pdf guy from wild child