Podiatry Coding & Billing Alert

Question: When it comes to diabetic shoe claims, can the certifying physician be any kind of provider?

Nebraska Subscriber

Answer: No. For diabetic shoe claims, the certifying physician can only be an M.D. or a D.O. No other medical professional can be the certifying physician. This includes podiatrists, physician assistants, nurse practitioners, or clinical nurse specialists.

Certifying physician defined: The certifying physician is responsible for diagnosing and treating the patient’s diabetic systemic condition through a comprehensive plan of care. The certifying physician must have an in-person visit with the patient where they discuss diabetes management within six months prior to the delivery of the patient’s diabetic shoes and/or inserts.

Don’t miss: The certifying physician must sign the certification statement on or after the date of the in-person visit and within three months prior to the delivery of the diabetic shoes/inserts.