Medicare
Theraputic Shoe Bill —
Diabetic Depth Shoes and Accomodative Inserts
Diabetes has reached epidemic proportions in the United States.
During the past decade, there has been an increase of 33% with
the diabetic population currently topping 16 million people.
There are many complications associated with diabetes
including kidney, heart, vision, circulatory and foot problems. Since diabetes
affects the vasculature, healing is often impaired or does not
occur at all.
The good news is that regardless of the type of diabetes, many
of these potential problems can be avoided as
a result of medication, life style changes and preventive care.
Amputations
Amputations, or partial amputations, of the feet
and legs are also growing at an alarming rate. Custom fit depth
shoes and inserts can stem the onset of many common foot defects
which may invite pain, disability and amputation. Diabetic complications
are in fact the leading cause of non-traumatic amputation in
the United States. Recently a task force was created by officials
from Medicare, the American Podiatric Medical Association and
the American Diabetes Association in order to explore ways to
reduce the number of amputations in the diabetic populations.
The number of these lower extremity amputations grew by 28% in
just the past several years. However, it has been determined
that over half of these amputations could have been prevented by
timely conservative foot care.
Custom molded accommodative inserts are an important part of
the diabetic patient's total foot care. They differ from traditional
orthotics in that their function is not to control the foot and
ankle, but to distribute the body weight evenly and eliminate
pressure spots which could develop ulceration. Diabetic ulceration
can be a daunting and deleterious complication of untreated or
uncontrolled diabetes and can lead to amputation or partial amputation
of the lower extremity. Dr. Wedemeyer works in concert with your
primary care or foot and ankle specialist to manage the Pedorthic
needs of the diabetic patient. He fits each Medicare qualified
patient yearly with custom depth shoes and inserts prescribed
by your primary care physician and their cost is covered by Medicare
and secondary insurance.
Insurance
Within a given calendar
year, the qualifying patient
can receive 80% of the allowed amounts for one pair
of depth shoes and three pairs of inserts OR one pair of custom
molded shoes (which include 1 pair of inserts) and two additional
pairs of inserts. Many Medicare recipients have secondary health
insurance coverage that will cover the additional 20% of charges.
Dr. Wedemeyer is a Medicare provider and SADMERC approved
supplier for yearly custom depth shoes and inserts
for those Medicare patients who qualify based on the following
criteria:
- The patient has type I or type II Diabetes Mellitus either
insulin dependent or dietary controlled.
* And: - The patient has one or more of the following conditions:
a) Previous amputation of the other foot, or part of either foot.
b) History of previous foot ulceration of either foot.
c) History of pre-ulcerative calluses of either foot.
d) Peripheral neuropathy with evidence of callus formation of either foot.
e) Foot deformity of either foot.
f) Poor circulation in either foot.
*A diagnosis of diabetes type I or II (along with the above
criteria) from your primary care M.D. or D.O. is required.
* Suppliers may not be able to dispense or submit claims for
devices to Medicare patients enrolled in Medicare managed care
plans.