About this policy
CMS National Coverage Determination | ncd_id=208 | manual_section=280.10 | coverage_level_code=1 | national_coverage_type=True | under_review=False | lab_ncd=False
Coverage indications
A prosthetic shoe (a device used when all or a substantial portion of the front part of the foot is missing) can be covered as a terminal device; i.e., a structural supplement replacing a totally or substantially absent hand or foot. The coverage of artificial arms and legs includes payment for terminal devices such as hands or hooks even though the patient may not require an artificial limb. The function of the prosthetic shoe is quite distinct from that of excluded orthopedic shoe and supportive foot devices which are used by individuals whose feet, although impaired, are essentially intact. (Section 1862(a)(8) of the Act excludes payment for orthopedic shoes or other supportive devices for the feet.)
Documentation requirements
Cross Reference: See the Medicare Benefit Policy Manual , Chapter 15 §130. Revision History: 5/1989 - Added statutory authority citation. Effective date NA. (TN 36) Benefit Categories: 4 - Artificial Legs, Arms, and Eyes Transmittal: transmittal_number=36 | transmittal_issue_date=1989-05-01
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
Backwork has no codes on record for this policy. Check the source.