23 Miss. Code. R. 203-6.2

Current through December 10, 2024

Rule 23-203-6.2 - Non-covered services

Medicaid does not cover the following:

A. Identification of culture of fungi in the toenail clippings is not covered.

A. Local anesthesia, digital blocks, or topical anesthesia done with a specific surgical procedure.

C. Cast applications/strapping/splinting charged separately from the initial surgery or fracture care on same day as initial surgery or fracture care.

D. Removal of casts/straps/splints.

E. Ultrasound on patients with diabetes.

F. Foot massage.

G. Whirlpool for mycotic nail treatment. H. Surgical trays.

I. Supplies.

J. Biopsies performed in conjunction with a surgical procedure.

K. Services for treatment of flat foot.

L. Services not medically necessary for the diagnosis and treatment of the condition of the foot.

M. Laboratory services performed by the DPM (Doctor of Podiatric Medicine) or referred to an independent laboratory by the DPM.

N. Services performed for conditions above the ankle unless within the scope of the podiatrist license.

O. Office visits with routine foot care procedures.

P. Routine foot examinations on all patients in a skilled nursing facility on a routine basis for screening purposes.

Q. Orthopedic shoes, any other type shoe, and/or supportive devices.

R. Routine foot care with debridement of nails on same date of service. Routine foot care may not be substituted for debridement of nails when the once every sixty day limit has been utilized.

S. Doppler (other than hand held Doppler), non-vascular diagnostic testing pertaining to a systemic disease.

T. Evaluation and advice for proper care of feet when the only service rendered for the management of paronychia. Debridement and avulsion may not be done on the same date of service.

U. Surgical or nonsurgical treatments provided for the sole purpose of correcting a subluxated structure in the foot as an isolate entity.

V. Palliative treatment of viral or plantar warts.

W. Routine foot care, in the absence of systemic conditions, including the following:

1. The cutting or removal or corns or calluses,

2. The trimming of nails, including the cutting, clipping, or debridement of ingrown toenails, club nails, or mycotic nails,

3. Fungal infections of the nail plates or mycotic nails with little or no symptomatology,

4. Avulsing small chips after trimming of the thickened/elongated nails that are painful, under the diagnosis of ingrown toenail,

5. Other hygienic and preventive maintenance care and any other service provided in the absence of localized illness, injury, or symptoms involving the foot, or

6. Routine soaking and application of topical medication.

23 Miss. Code. R. 203-6.2

Miss. Code Ann. § 43-13-121