Diabetic Shoe Documentation Guidelines and Medical Requirements
Learn about the essential documentation guidelines for prescribing diabetic shoes, including the need for a written prescription, certifying statement, and comprehensive plan of care. Discover the medical criteria necessary for patients to qualify for diabetic/therapeutic shoes and the importance of detailed medical documentation in the patient's records.
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Presentation Transcript
DIABETIC SHOE DOCUMENTATION GUIDELINES
PRESCRIPTION A written prescription order is required from the ordering physician up front for diabetic/therapeutic shoes. The written order form may be used for this purpose or a written prescription containing this required information.
CERTIFYING STATEMENT A statement of certification for therapeutic shoe and inserts is also required to be signed and dated within 3 months prior to delivery of shoes The certifying physician must be an MD or DO and may NOT be a Podiatrist, PA, Nurse Practitioner or clinical nurse specialist.
KEENE MEDICAL ORDER FORM FOR DIABETIC SHOES CAN BE FOUND AT: HTTPS://WWW.KEEN EMEDICALPRODUCT S.NET/ORDERFORMS This form contains the Prescription and Certifying Statement all in one The MD/DO can complete and sign both areas OR The MD/DO can complete and sign the top Certifying Statement with the Ordering physician (podiatrist) completing and signing the bottom prescription portion
A. The patient must have Diabetes Mellitus. B. The patient has to have one or more of the following conditions: 1. History of partial or complete amputation of foot 2. History of previous foot ulceration 3. Peripheral neuropathy with evidence of callous formation 4. History of pre-ulcerative callous 5. Foot deformity 6. Poor circulation C. Patient must have a documented Comprehensive Plan of Care for Diabetes management MEDICAL GUIDELINES
THERE MUST BE QUALIFYING MEDICAL DOCUMENTATION IN THE MEDICAL RECORD The certifying physician (MD/DO) must document the comprehensive plan of care for diabetes management The certifying physician (MD/DO) must document one or more of criteria 1 6 listed on the previous slide in the medical record of an in-person visit within 6 months prior to delivery of the shoes/inserts and prior to or on the same day as signing the certification statement; OR Obtain, initial, date and indicate agreement with information from the medical records of an in-person visit with a podiatrist, other M.D or D.O., physician assistant, nurse practitioner, or clinical nurse specialist that is within 6 months prior to delivery of the shoes/inserts, and that documents one of more of criteria 1-6 listed on the previous slide.
