HI 00620.180 Excluded Foot Care Services

Covered foot care services are restricted by types of service under both Part A and Part B.

A. Treatment of flat foot conditions and prescriptions of supportive devices therefor

Treatment of “flat foot conditions” means treatment of the local condition of flattened arches regardless of the underlying pathology causing it, except when such treatment is purely incidental to and an integral part of covered foot treatment (e.g., treatment of a fracture).

B. Treatment of subluxation of the feet

The term “subluxation” refers to structural misalignments of the joints of the feet (except fractures and complete dislocations) which do not require treatment by surgical methods. Excluded “treatment” includes evaluations as well as the nonsurgical measures, supplies, or appliances used to correct the condition or alleviate symptoms. The exclusion does not apply where such treatment is purely incidental to and an integral part of covered foot treatment (such as treatment of a fracture) or where performed as a part of postoperative care during the period of convalescence from covered foot surgery.

This exclusion does not apply to the ankle joint.

C. Routine foot care

Routine foot care includes the cutting or removal of corns, or calluses, the trimming of nails, and other hygienic and preventive maintenance care in the realm of self-care, such as cleaning and soaking the feet, the use of skin creams to maintain skin tone of both ambulatory and bedfast patients, and any services performed in the absence of localized illness, injury, or symptoms involving the foot. Foot care such as routine soaking and application of topical medication on a physician's order between required visits to the physician is not covered.

NOTE: Effective July 1, 1981, the treatment of warts (including plantar warts) is no longer considered routine foot care. As a result, services provided for the treatment of warts on the foot are covered to the same extent as services provided for the treatment of warts located elsewhere on the body.

Hygienic and other care which is simply incidental to and an integral part of active covered treatment of foot lesions, such as infections and diabetic ulcers, is not considered as “routine” care and hence is not excluded.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0600620180
HI 00620.180 - Excluded Foot Care Services - 03/12/1999
Batch run: 04/06/2015
Rev:03/12/1999