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Ohio Administrative Code (Last Updated: January 12, 2021) |
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5160 Medicaid |
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Chapter5160-7. Podiatric Services |
5160-7-02. Podiatric medicine: scope of coverage
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(A) Podiatric physicians may receive medicaid payment for covered services (as defined in Chapter 5160-7 of the Administrative Code) which consist of the medical, mechanical and surgical treatment of ailments of the foot, the muscles and tendons of the leg governing the foot, and superficial lesions of the hand other than those associated with trauma. The podiatric physician may also receive medicaid payment for treatment of the local manifestation of systemic disease as they appear in the hand and foot, but the individual must be concurrently referred to an eligible prescriber for treatment of the systemic disease itself.
(B) Podiatric medicine services provided by non-physicians under the direct and general supervision of a podiatric physician are covered in accordance with rule 5160-4-02 of the Administrative Code.
(C) Hospital-based podiatric physicians and surgeons are covered in accordance with rule 5160-4-01 of the Administrative Code.
(D) Podiatric medicine services provided in a teaching setting are covered as set forth in rule 5160-4-05 of the Administrative Code.
(E) Podiatric medicine services provided in a long-term care setting are covered as detailed in rules 5160-3-19 and 5123:2-7-11 of the Administrative Code.
(F) Podiatric medicine services provided by a physician assistant are covered in accordance with rule 5160-4-03 of the Administrative Code.
(G) By report services are covered in accordance with rule 5160-4- 02.1 of the Administrative Code. For these services, a provider must submit a report documenting the following:
(1) Complete description of the services or procedures;
(2) Diagnosis, both preoperative and postoperative;
(3) Size, location, and number of lesions;
(4) Indication of primary, secondary, or tertiary procedure;
(5) The nearest similar current procedural terminology (CPT) code whenever possible;
(6) Estimated number of visits for follow-up; and
(7) Operative time.