Foot and Ankle
High Blood Pressure
On-the-Job Foot Health
Rear Foot Surgery
Podiatric medicine is a
branch of the health sciences devoted to the medical and surgical care
of the foot and ankle, and related or governing structures. A doctor of
podiatric medicine (DPM) specializes in the prevention, diagnosis, and
treatment of foot and ankle disorders resulting from injury or disease.
A DPM makes independent medical judgments, prescribes medications, and
when necessary performs surgery.
Podiatrists help our
aging population to remain active and independent by keeping them
ambulatory. Congress recognized this important relationship between foot
health and general health when it included the services of podiatric
physicians in the Medicare legislation.
Misconceptions of Medicare
Medicare coverage can often
be confusing. The rules and regulations can easily be misunderstood by
patients. One misconception is that Medicare covers only surgical
procedures, and not medical care or routine foot care.
In truth, Medicare will
cover routine foot care. According to the Medicare Rules and Regulations
Manual, "Certain foot care procedures that are generally considered
to be routine -- e.g., cutting or removal of nails, calluses or corns --
may pose a hazard when performed by a nonprofessional person on patients
with a systemic condition that has resulted in severe circulatory
problems or areas of desensitization in the legs or feet. Routine foot
care performed under these circumstances is covered."
The manual also states,
"Services ordinarily considered routine are also covered if they
are performed as a necessary and integral part of otherwise covered
services such as the diagnosis and treatment of diabetic ulcers, wounds,
Treatment of diabetic
foot conditions, both medically and surgically, is therefore covered by
Medicare. Treatment of broken toes, of burns, and of arthritic
conditions -- gout, for example -- are others. (The misconceptions that
Medicare covers only surgery may be caused by the fact that the Medicare
code numbers assigned to diabetic treatment such as that mentioned in
the manual, and other nonsurgical procedures, are listed under the
"surgical" section of the code book.)
Coverage Under Medicare
If you have signed up for medical insurance (Part B)
under Medicare, you are covered for certain services of podiatrists and
other doctors for:
Certain foot care services are not covered, no matter
whether they are performed by podiatrists, medical doctors, or
osteopaths. They are:
- Medical and surgical services in the hospital,
skilled nursing facility, office, or your home. The same action also
provided that podiatrists can certify and recertify medical
necessity for hospitalization, skilled nursing care, and home health
- Payment for routine foot care may be made for such
care only when it would be hazardous to the health of the patient if
self-treatment were performed. For example, when a beneficiary is
under the care of a doctor for diabetes, circulatory ailments or
certain other conditions, and evidences complicating local symptoms,
routine foot care is a covered service.
- Other prescribed health services, including
diagnostic x-ray, surgical treatment, fracture casts, and leg or
ankle braces that are attached to the outside of the shoe.
- Drugs which cannot be self-administered, and which
are administered to you as a part of professional services.
- Full reasonable charges for radiology and pathology
services as a bed patient in a hospital, if you have both hospital
and medical insurance.
Reimbursement Under Medicare
- Routine foot care. This includes the cutting or
removal of corns or calluses, trimming of nails, and routine
hygienic care, except as noted above.
- Treatment of flat-foot conditions, including arch
- Treatment of partial dislocations.
Your medical insurance (Part B of Medicare) helps pay
for the services of podiatrists and other doctors, out-patient hospital
services, medical services and supplies, and other health care services.
Subscribers to medical insurance pay a monthly
premium, and the Federal government covers the remaining costs of the
program. Medical insurance pays 80 percent of the Medicare-allowed
amount, after the individual pays an annual deductible for covered
services connected with the diagnosis or treatment of illness and
injuries. Payment for services of a podiatrist or another doctor can be
made as follows:
In either case, you are responsible for the annual
deductible and the 20 percent coinsurance amounts. Under either of these
two payment options, the podiatrist is required to complete the
necessary Medicare claim forms for you.
- 1. If you and your podiatrist agree, application
for the medical insurance payment for covered services will be made
by the podiatrist who will receive the payment directly from
- If you desire it, you may pay the doctor directly,
and the medical insurance payment can be made directly to you.
Note that, in some cases, you may also be charged
amounts in excess of the Medicare-allowed fees, and for services not
covered under the Medicare program.
See "Your Medicare Handbook" for more
Prompt Care Of Foot Disorders
With advancing years, the skin and nails of the feet
frequently become dry and brittle, and numbness and discoloration often
are present. These may be the first signs of such serious conditions as
diabetes, arthritis, and circulatory disease. Ignoring these symptoms
and failing to seek prompt professional medical care when they appear
can have serious consequences for patients, especially the elderly.
Foot Problems Can Be Prevented
Whether the older person lives at home or elsewhere,
preventive foot care can:
Consult Your Podiatrist
- Increase comfort
- Improve or maintain mobility and independence
- Limit the possibility of additional medical
- Reduce the chances of hospitalization
- Lessen requirements for other institutional care
You may receive treatment from your podiatrist in the
office, your home, the hospital, a nursing home, or an extended care
facility. Always consult your podiatrist when you have questions about
foot conditions or what is covered by Medicare.