Podiatry Coding & Billing Alert

Question: One of my diabetic Medicare patients is a carpenter who requires work boots for his job. Is there a code for this type of diabetic shoe, or will he only qualify for inserts in regular work boots?Virginia SubscriberAnswer: Coding the situation you describe can be tricky because the rules for diabetic shoes change from carrier to carrier. For the state of Virginia, you should consult CIGNA Government Services, the Durable Medical Equipment Medicare Administrative Contractor (DME MAC) for Jurisdiction C, which includes Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, U.S. Virgin Islands, Virginia, and West Virginia.In terms of the footwear itself, there are three possible options for this patient. One is for the podiatrist to prescribe a hightop boot (report HCPCS code L3649, Orthopedic shoe, modification, addition or transfer, NOS), which would provide the appropriate biomechanical control to [...]