Md. Code Regs. 10.09.15.04

Current through Register Vol. 51, No. 25, December 13, 2024

Section 10.09.15.04 - Covered Services

The Program covers the following medically necessary services:

A. Podiatric services rendered in the podiatrist's office, the participant's home, a hospital, a nursing facility, a free standing clinic, or elsewhere, when these services are:

(1) Performed by the podiatrist or another licensed podiatrist in the podiatrist's employ;

(2) Performed on the:

(a) Human foot or ankle;

(b) Anatomical structures that attach to the human foot; or

(c) Soft tissue below the midcalf

(3) Clearly related to the participant's individual medical needs as diagnostic, curative, palliative, or rehabilitative services; and

(4) Adequately described on the participant's medical record.

B. Routine podiatric care rendered in an office, home, nursing home, or licensed assisted living facility for participants who have a metabolic, neurologic, or vascular disease affecting the lower extremities, including but not limited to:

(1) Arteriosclerosis obliterans (A.S.O., arteriosclerosis of the extremities, occlusive peripheral arteriosclerosis);

(2) Buerger's disease (thromboangiitis obliterans);

(3) Peripheral neuropathies involving the feet, associated with:

(a) Traumatic injury;

(b) Leprosy or neurosyphilis; or

(c) Hereditary disorders, such as hereditary sensory radicular neuropathy, angiokeratoma corporis diffusum (Fabry's) and amyloid neuropathy; and

(4) The following conditions, if the patient is under the active care of a doctor of medicine or osteopathy who documents the condition:

(a) Diabetes mellitus;

(b) Chronic thrombophlebitis;

(c) Peripheral neuropathies involving the feet, associated with:

(i) Malnutrition and vitamin deficiency such as malnutrition (general and pellagra), alcoholism, malabsorption (celiac disease and tropical sprue), and pernicious anemia;

(ii) Carcinoma;

(iii) Diabetes mellitus;

(iv) Drugs and toxins;

(v) Multiple sclerosis; or

(vi) Uremia (chronic renal disease).

C. Drugs dispensed by the podiatrist in an emergency or drugs which cannot be self-administered within the limitations of COMAR 10.09.03;

D. Injectable drugs administered by the podiatrist within the limitations of COMAR 10.09.03;

E. Medical equipment and supplies prescribed by the podiatrist within the limitations of COMAR 10.09.12; and

F. Emergency services and related follow-up care.

Md. Code Regs. 10.09.15.04

Regulation .04 amended effective 45:14 Md. R. 696, eff. 7/16/2018