WebDIABETIC SHOE DOCUMENTATION CHECKLIST The following documentation is required in order for us to provide Diabetic shoes and inserts. Please obtain this information prior to scheduling an appointment Fill & Sign Online, Print, Email, Fax, or Download Get Form Form Popularity Get Form eSign Fax Email Add Annotation Not the form you were …

Diabetic Shoes Checklist -Medicare Part B - AuBurn Pharmacies

WebCGS Medicare Webshoes with inserts or custom molded shoes with inserts (in this paragraph referred to as ‘therapeutic shoes’) for an individual with diabetes, if— (A) the physician who is managing the individual’s diabetic condition— 1 A Medicare allowed NPP is defined as a nurse practitioner, clinical nurse specialist, or physician assistant (as bishop family dental utah

Forms & Checklists - CGS Medicare

http://www.ncpa.co/pdf/do-diabetic-shoe-checklist.pdf WebPrescription for Diabetic Shoes and Inserts SafeStep will create and fax to MD: 3. Physician Notes on Qualifying Condition(s) 4. Statement of Certifying Physician ... Performing evaluation satisfies Medicare requirement to document medical necessity for shoes. Patient visit may be billable as 99213 if there is documented change in patient’s ... WebMedical records of diabetes management (not older than 6 months and signed/co signed by MD or DO) Documents required for fitting/ delivery of diabetic shoes: D Checklist for … bishop falls newfoundland weather