Routine Foot Care and Debridement of Nails

Medicare generally excludes routine foot care but covers specific exceptions when there is severe systemic disease (metabolic, neurologic, or peripheral vascular) or significant peripheral neuropathy that places the patient at risk if cared for by a nonprofessional. Coverage is also allowed for specific toenail disorders (onychogryphosis, onychauxis) when there is marked limitation of ambulation, pain, and/or secondary infection, and for mycotic nails when medical necessity criteria are met; required clinical findings and ICD-10 support must be documented, and codes marked with an asterisk require active MD/DO care within six months prior to service.

"Routine foot care is covered when the patient has a systemic disease (metabolic, neurologic, or peripheral vascular) of sufficient severity that performance of such services by a nonprofessional pe..."

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