Revenue Cycle Insider

Question: Our podiatrist examines the patient, prescribes therapeutic diabetic shoes, and then provides the shoes directly from the office. Is it acceptable for the prescribing practitioner to also be the supplier of the shoes, or does the supplier need to be a separate entity?

Ohio Subscriber

Answer: The provider who orders the durable medical equipment (DME) can also supply it. In many cases, the practitioner who writes the order for the therapeutic shoes also supplies them. A podiatry practice may manage the entire process, including the foot evaluation, shoe prescription, and delivery appointment to verify proper fit and function. It can be important to understand the roles of each professional when it comes to properly reporting diabetic shoes, however:

• Certifying physician: The certifying physician must be an MD or DO. The certifying physician is responsible for diagnosing and treating the patient’s diabetic systemic condition through a comprehensive plan of care. The certifying physician cannot be a podiatrist or clinical nurse specialist (CNS).
• Prescribing practitioner: The prescribing practitioner writes the order for the therapeutic shoes, modifications, and inserts. This practitioner must be experienced in the fitting of diabetic shoes and inserts. They may be a podiatrist, MD, DO, physician assistant (PA), nurse practitioner (NP), or CNS. They may also be the supplier of the DME.
• Supplier: The supplier furnishes the shoes, modifications, and/or inserts to the patient. This person may be a podiatrist, pedorthist, orthotist, prosthetist, or another qualified individual. The prescribing practitioner may also be the supplier.

Make note: The certifying physician may only be the supplier if they are practicing in a defined rural area or a defined health professional shortage area.

Lindsey Bush, BA, MA, CPC, Production Editor, AAPC