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22 CCR 51310
22 CCR 51310
§ 51310. Podiatry Services. Editorial Note: For full incorporation by reference of the Physicians' Current Procedural Terminology Codes, see CCR, Title 22, section 51050.
(a)
Services provided by podiatrists, acting within the scope of their practice as authorized by California law, are covered subject to the following:
(1)
Podiatric office visits described by procedure codes 99201-99203 and 99211-99213 in the latest edition of the Physicians' Current Procedural Terminology are covered as medically necessary. All other outpatient podiatry services are subject to prior authorization and are limited to medical and surgical services necessary to treat disorders of the feet, ankles, or tendons that insert into the foot, secondary to or complicating chronic medical diseases, or which significantly impair the ability to walk.
(2)
Podiatry services rendered on an emergency basis are exempt from prior authorization. Emergency services shall conform to and be in compliance with the provisions of section 51056.
(3)
Podiatry services rendered to hospital, skilled nursing facility or intermediate care facility inpatients are covered only when provided pursuant to an order on the patient's chart, signed by the physician or podiatrist who admitted the patient, specifying the care to be given. Services to skilled nursing facility and intermediate care facility inpatients are further subject to prior authorization.
(4)
Hospitalization of patients by podiatrists is subject to the procedures set forth in section 51327. Podiatry services provided to hospital inpatients are covered only to the extent that the period of hospitalization is covered by the program.
(b)
Routine nail trimming is not covered.
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