Page 276 - Medicare Benefit Policy Manual

Beginning in CY 2016, CMS will treat an AWV and voluntary ACP that are furnished on
the same day and by the same provider as a preventive service. Voluntary ACP services,
upon agreement with the patient, will be an optional element of the AWV. (See section
1861(hhh)(2)(G) of the Act.) When ACP services are furnished as a part of an AWV,
according to sections 1833(a)(1) and 1833(b)(10) of the Act, the coinsurance and
deductible are waived.

Voluntary advance care planning means the face-to-face service between a physician (or
other qualified health care professional) and the patient discussing advance directives,
with or without completing relevant legal forms. An advance directive is a document
appointing an agent and/or recording the wishes of a patient pertaining to his/her medical
treatment at a future time should he/she lack decisional capacity at that time.

See Pub. 100-04, Medicare Claims Processing Manual, chapter 18, section 140.8 for
claims processing and billing instructions.

290 - Foot Care
(Rev. 1, 10-01-03)
A3-3158, B3-2323, HO-260.9, B3-4120.1

A. Treatment of Subluxation of Foot

Subluxations of the foot are defined as partial dislocations or displacements of joint
surfaces, tendons ligaments, or muscles of the foot. Surgical or nonsurgical treatments
undertaken for the sole purpose of correcting a subluxated structure in the foot as an
isolated entity are not covered.

However, medical or surgical treatment of subluxation of the ankle joint (talo-crural
joint) is covered. In addition, reasonable and necessary medical or surgical services,
diagnosis, or treatment for medical conditions that have resulted from or are associated
with partial displacement of structures is covered. For example, if a patient has
osteoarthritis that has resulted in a partial displacement of joints in the foot, and the
primary treatment is for the osteoarthritis, coverage is provided.

B. Exclusions from Coverage

The following foot care services are generally excluded from coverage under both Part A
and Part B. (See §290.F and §290.G for instructions on applying foot care exclusions.)

1. Treatment of Flat Foot

The term “flat foot” is defined as a condition in which one or more arches of the foot
have flattened out. Services or devices directed toward the care or correction of such
conditions, including the prescription of supportive devices, are not covered.

2. Routine Foot Care