decisionhealth Newsletters, Answer Books - 2006 Issue 7 (July)
Medicare_Benefit_Policy_Manual / Chapter_15 / 290
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Article Overview
This article summarizes Medicare’s policy framework for foot care services under Chapter 15, Section 290 of the Medicare Benefit Policy Manual. It covers the broad categories of foot care that are generally excluded, the circumstances in which otherwise routine services may be considered covered, and the documentation and review concepts that affect claims processing. It is intended for clinicians, podiatrists, coders, and billing staff who need to understand the scope of Medicare foot care coverage guidance.
Why This Topic Matters
Foot care claims are frequently affected by exclusions, exceptions, and documentation requirements, so understanding this policy helps reduce avoidable denials and supports accurate billing review.
Article Sections
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A - Treatment of Subluxation of Foot
Explains the article’s discussion of subluxation-related foot care coverage and related treatment considerations.
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B - Exclusions from Coverage
Outlines broad categories of foot care services that are generally excluded under Medicare policy.
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C - Exceptions to Routine Foot Care Exclusion
Describes the general types of circumstances that may qualify routine foot care services for coverage consideration.
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D - Systemic Conditions That Might Justify Coverage
Summarizes the categories of systemic conditions discussed as potentially relevant to foot care coverage evaluation.
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E - Supportive Devices for Feet
Addresses policy language related to supportive footwear and related device coverage considerations.
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F - Presumption of Coverage
Covers the clinical findings and review framework used in the article’s coverage presumption discussion.
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G - Application of Foot Care Exclusions to Physician’s Services
Discusses how foot care exclusions are applied when services are performed by different physician types and in mixed-service claims.
What You Will Learn
- How Medicare frames foot care coverage limitations and exceptions.
- Which broad categories of foot services are generally excluded from coverage.
- What kinds of systemic conditions and clinical findings are discussed in relation to foot care review.
- How the policy addresses documentation and claim review concepts for foot care services.
- How exclusions may apply to physician and podiatry services in billing review.
Who Should Read This
- Podiatrists
- Physicians
- Medical coders
- Billing staff
- Revenue cycle staff
- Compliance staff
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