Therapeutic Shoes - JA DME
Therapeutic Shoes for Persons with Diabetes
- Therapeutic Shoes for Persons with Diabetes Local Coverage Determination (LCD) and Policy Article [PDF]
- Clinician Letter - Medical Records [PDF] - Letter may be sent to clinicians to assist in obtaining documentation
- Physician Letter - Documentation Requirements [PDF] - Letter may be sent to clinicians to assist in obtaining documentation
- Statement of Certifying Physician for Therapeutic Shoes
- Therapeutic Shoes for Persons with Diabetes Documentation Checklist [PDF] - Checklist to ensure suppliers gather all required documentation
- Medical Review - View notifications/findings of pre/post claim reviews completed by Noridian Medical Review
|RT/LT Modifiers||Effective for claims with dates of service (DOS) on or after 3/1/2019, suppliers must bill each item on two separate claim lines using the RT and LT modifiers and 1 UOS on each claim line. Claim lines for HCPCS codes requiring use of the RT and LT modifiers, billed without the RT and/or LT modifiers or with the RTLT on a single claim line, will be rejected as incorrect coding|
- Clarification of Criterion 5 - Per the LCD, "The in-person evaluation of the beneficiary by the supplier at the time of delivery…must be conducted with the beneficiary wearing the shoes and inserts and must document that the shoes/inserts/modifications fit properly."
- Toe Fillers and Diabetic Shoe Inserts - Shoe inserts for beneficiaries with missing toes or partial foot amputations who are not diabetic are considered for coverage under the prosthetic benefit
Last Updated Fri, 24 Apr 2020 21:13:21 +0000
The below are topic specific articles which have been published to "Latest Updates" and sent out in Noridian emails within the past two years. Exclusions to this include time sensitive related announcements such as: Noridian and CMS educational events, Ask-the-Contractor Teleconferences and claims processing downtime.