55 Pa. Code § 1143.2
The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:
Chronic condition-An illness which frequently recurs or persists for a period in excess of 3 months.
Compensable service-A benefit to which a MA recipient is entitled under the MA Program.
Consultation-A medical evaluation conducted by a specialist at the request of the attending practitioner. For the purposes of the MA Program, a consultation includes taking a medical history, examining the patient, and preparing a written report that is incorporated into the patient's record.
Experimental procedure-A procedure that deviates from customary standards of medical practice, is not routinely used in the medical or surgical treatment of a specific illness or condition, or is not of proven medical value.
Medical justification-Written documentation in the patient's medical record indicating the specific health condition or risk that makes the particular service the podiatrist renders, orders or prescribes medically necessary.
Medically necessary-A term used to describe those medical conditions for which treatment is necessary, as determined by the Department, and which are compensable under the MA Program.
Molded shoes-Shoes that are constructed from a special last conforming to a specific individual's feet. Molded shoes are constructed from leather or other durable material.
Noncompensable service-A service a provider furnishes for which there is no provision for payment under this chapter.
Nonemergency medical services-A compensable podiatrists' service provided for conditions not requiring immediate medical intervention in order to sustain the life of the person or to prevent damage to health.
Orthopedic shoes-Shoes that have a Goodyear welt, steel shank and elongated medial counter which are modified to compensate for an abnormality of the feet.
Shoe insert-A device that is constructed of plexiglass, hard plastic or other rigid material fashioned for the individual feet by a laboratory approved to participate in the MA Program, and is fabricated according to a podiatrist's prescription.
55 Pa. Code § 1143.2
This section cited in 55 Pa. Code § 1143.58 (relating to noncompensable services and items).