DHS 107.06(4)(cm)3.3. The consulting provider provides a written report that becomes a part of the recipient’s permanent medical record.
DHS 107.06(4)(d)(d) Foot care.
DHS 107.06(4)(d)1.1. Services pertaining to the cleaning, trimming, and cutting of toenails, often referred to as palliative care, maintenance care, or debridement, shall be reimbursed no more than one time for each 31-day period and only if the recipient’s condition is one or more of the following:
DHS 107.06(4)(d)1.a.a. Diabetes mellitus;
DHS 107.06(4)(d)1.b.b. Arteriosclerosis obliterans evidenced by claudication; or
DHS 107.06(4)(d)1.c.c. Peripheral neuropathies involving the feet, which are associated with malnutrition or vitamin deficiency, carcinoma, diabetes mellitus, drugs and toxins, multiple sclerosis, uremia or cerebral palsy.
DHS 107.06(4)(d)2.2. The cutting, cleaning and trimming of toenails, corns, callouses and bunions on multiple digits shall be reimbursed at one inclusive fee for each service which includes either one or both appendages.
DHS 107.06(4)(d)3.3. For multiple surgical procedures performed on the foot on the same day, the physician shall be reimbursed for the first procedure at the full rate and the second and all subsequent procedures at a reduced rate as determined by the department.
DHS 107.06(4)(d)4.4. Debridement of mycotic conditions and mycotic nails shall be a covered service in accordance with utilization guidelines established and published by the department.
DHS 107.06(4)(d)5.5. The application of unna boots is allowed once every 2 weeks, with a maximum of 12 applications for each 12-month period.
DHS 107.06(4)(f)(f) Services performed under a physician’s supervision. Services performed under the supervision of a physician shall comply with federal and state regulations relating to supervision of covered services. Specific documentation of the services shall be included in the recipient’s medical record.
DHS 107.06(4)(g)(g) Dental services. Dental services performed by a physician shall be subject to all requirements for MA dental services described in s. DHS 107.07.
DHS 107.06(4)(h)(h) Obesity-related procedures. Gastric bypass or gastric stapling for obesity is limited to medical emergencies, as determined by the department.
DHS 107.06(4)(i)(i) Abortions.
DHS 107.06(4)(i)1.1. Abortions, both surgically-induced and drug-induced, are limited to those that comply with s. 20.927, Stats.
DHS 107.06(4)(i)2.2. Services, including drugs, directly related to non-surgical abortions shall comply with s. 20.927, Stats., may only be prescribed by a physician, and shall comply with MA policy and procedures as described in MA provider handbooks and bulletins.
DHS 107.06(5)(5)Non-covered services. The following services are not covered services:
DHS 107.06(5)(a)(a) Services and items that are provided for the purpose of enhancing the prospects of fertility in males or females, within the meaning of s. DHS 107.03 (19).
DHS 107.06(5)(b)(b) Abortions performed which do not comply with s. 20.927, Stats.;
DHS 107.06(5)(d)(d) As separate charges, preoperative and postoperative surgical care, including office visits for suture and cast removal, which commonly are included in the payment of the surgical procedure;
DHS 107.06(5)(e)(e) As separate charges, transportation expenses incurred by a physician, to include but not limited to mileage;
DHS 107.06(5)(f)(f) Dab’s and Wynn’s solution;
DHS 107.06(5)(g)(g) Except as provided in sub. (3) (b) 1., a hysterectomy if it was performed solely for the purpose of rendering an individual permanently incapable of reproducing or, if there was more than one purpose to the procedure, it would not have been performed but for the purpose of rendering the individual permanently incapable of reproducing;
DHS 107.06(5)(h)(h) Ear piercing;
DHS 107.06(5)(i)(i) Electrolysis;
DHS 107.06(5)(j)(j) Tattooing;
DHS 107.06(5)(k)(k) Hair transplants;
DHS 107.06(5)(L)(L) Vitamin C injections;
DHS 107.06(5)(m)(m) Lincocin (lincomycin) injections performed on an outpatient basis;