Podiatry Coding & Billing Alert

Question: We are currently billing A5500 and A5513 for shoes for diabetic Medicare patients. Are these correct? Illinois Subscriber Answer: Codes A5500 (For diabetics only, fitting [including follow-up], custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert[s], per shoe) and A5513 (For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of Shore A 35 durometer or higher, includes arch filler and other shaping material, custom fabricated, each) correctly apply to footwear prescribed for diabetic Medicare patients. Codes for diabetic shoes have very different descriptions, however, so you should check the specifications of the shoes to make sure that they match codes you report. Check this out: You'll use A5500 for an adjustable depth shoe that: • has a full length, heel-to-toe filler that when removed provides a minimum [...]