DHS 107.14(2)(a)9.9. Cerebrovascular accident; or
DHS 107.14(2)(a)10.10. Scleroderma.
DHS 107.14(2)(b)(b) The cutting, cleaning and trimming of toenails, corns, callouses and bunions on multiple digits shall be reimbursed at one fee for each service which includes either one or both feet.
DHS 107.14(2)(c)(c) Initial diagnostic services are covered when performed in connection with a specific symptom or complaint if it seems likely that treatment would be covered even though the resulting diagnosis may be one requiring non-covered care.
DHS 107.14(2)(d)(d) Physical medicine modalities may include, but are not limited to, hydrotherapy, ultrasound, iontophoresis, transcutaneous neurostimulator (TENS) prescription, and electronic bone stimulation. Physical medicine is limited to 10 modality services per calendar year for the following diagnoses only:
DHS 107.14(2)(d)1.1. Osteoarthritis;
DHS 107.14(2)(d)2.2. Tendinitis;
DHS 107.14(2)(d)3.3. Enthesopathy;
DHS 107.14(2)(d)4.4. Sympathetic reflex dystrophy;
DHS 107.14(2)(d)5.5. Subclacaneal bursitis; and
DHS 107.14(2)(d)6.6. Plantar fascitis, as follows:
DHS 107.14(2)(d)6.a.a. Synovitis;
DHS 107.14(2)(d)6.b.b. Capsulitis;
DHS 107.14(2)(d)6.c.c. Bursitis; or
DHS 107.14(2)(d)6.d.d. Edema.
DHS 107.14(2)(e)(e) Services provided during a nursing home visit to cut, clean or trim toenails, corns, callouses or bunions of more than one resident shall be reimbursed at the nursing home single visit rate for only one of the residents seen on that day of service. All other claims for residents seen at the nursing home on the same day of service shall be reimbursed up to the multiple nursing home visit rate. The podiatrist shall identify on the claim form the single resident for whom the nursing home single visit rate is applicable, and the residents for whom the multiple nursing home visit rate is applicable.
DHS 107.14(2)(f)(f) Debridement of mycotic conditions and mycotic nails is a covered service provided that utilization guidelines established by the department are followed.
DHS 107.14(3)(3)Non-covered services. The following are not covered services:
DHS 107.14(3)(a)(a) Procedures which do not relate to the diagnosis or treatment of the ankle or foot;
DHS 107.14(3)(b)(b) Palliative or maintenance care, except under sub. (2);
DHS 107.14(3)(c)(c) All orthopedic and orthotic services except plaster and other material cast procedures and strapping or tape casting for treating fractures, dislocations, sprains or open wounds of the ankle, foot or toes;
DHS 107.14(3)(d)(d) Orthopedic shoes and supportive devices such as arch supports, shoe inlays and pads;
DHS 107.14(3)(e)(e) Physical medicine exceeding the limits specified under sub. (2) (d);
DHS 107.14(3)(f)(f) Repairs made to orthopedic and orthotic appliances;
DHS 107.14(3)(g)(g) Dispensing and repairing corrective shoes;
DHS 107.14(3)(h)(h) Services directed toward the care and correction of “flat feet;”
DHS 107.14(3)(i)(i) Treatment of subluxation of the foot; and
DHS 107.14(3)(j)(j) All other services not specifically identified as covered in this section.
DHS 107.14 HistoryHistory: Emerg. cr. eff. 7-1-90; cr. Register, January, 1991, No. 421, eff. 2-1-91.