Covered without prior authorization (high confidence)
Key Coverage Criteria
I. Foot care services including cutting or removal of corns or calluses, or trimming, cutting, clipping or debriding of nails are consideredmedically necessarywhen the following criteria are met:
The individual has a systemic condition resulting in circulatory insufficiency or desensitization of the lower extremity including, but not limited to,one or moreof the conditions listed below:Diabetes mellitus;orPeripheral vascular disease;orPeripheral neuropathy;and
Diabetes mellitus;or
Peripheral vascular disease;or
Peripheral neuropathy;and
The individual is at increased risk of infection or poor wound healing from the underlying medical condition;and