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NC Division of Medical Assistance |
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DMA Clinical Policy and Programs
Phone Number 919-855-4320
Fax 919-733-2796
Podiatry services are the surgical, medical or mechanical treatment of ailments of the human foot and ankle and their soft tissue structure to the level of the myelotendinous junction. The NC General Statutes (NCGS 90-202.2) exclude from the definition of podiatry the following: amputation of the entire foot, the administration of an anesthetic or other local and surgical correction of clubfoot of an infant or child two years of age or less. For service requirements, coverage criteria, and limitations, refer to Clinical Coverage Policy #1C-1, Podiatry Services.
Medically necessary routine foot care is covered only for specific conditions. Curettement procedures or shaving of lesion procedures are reviewed to determine if service is routine foot care. Podiatry services for recipients of Medicaid for Pregnant Women (Baby Love recipients) require prior approval. For service requirements, coverage criteria, and limitations, refer to Clinical Coverage Policy #1C-2, Medically Necessary Routine Foot Care.
For changes and updates to coverage criteria, billing information, and other program requirements refer to the N.C. Medicaid general and special bulletins.
