Protecting the At-Risk Foot
If you have medical insurance and are diagnosed with diabetes and foot complications, you may have coverage for therapeutic footwear at little or no out-of-pocket or up-front cost.
If you have a prescription, we can schedule your first appointment, usually 45-60 minutes in duration. You will receive an examination, get fitted for depth shoes and have your feet molded for orthotics.
* REMEMBER TO BRING:
Contact information for the MD or DO who manages your Diabetes.
With your permission, Boston Pedorthic compliance staff will request required documentation from your clinical team. When the paperwork is harmonized, your second appointment can be scheduled, usually within ten days or less - and you can received your footwear.
The second appointment takes 30-45 minutes.
Boston Pedorthic is Contracted With:
Blue Cross Blue Shield
Commonwealth Care Alliance
Mass Health, secondary to Medicare
Senior Whole Health
Tufts Health Plan
With Prior Approval:
Kindly have your ID numbers handy when you call for an appointment. This way, we can verify eligibility & benefits before your appointment.
To get going, you will need a Prescription. Our staff will help you get the other documentation:
Clinical Notes, detailing the complication, secondary to Diabetes, which is stated on your SCP. These Clinical Notes must be signed by your Certifying Physician
Evidence that you have seen your certifying physician within the past six months.
These forms may be faxed to Boston Pedorthic at (270)-747-8779.
See Dear Physician Letter from CMS Medicare for a more detailed explanation of the documentation requirements.
PROTECTING AT-RISK FEET
People with Diabetes, who are diagnosed by their doctor to have complications of neuropathy and circulatory deficiencies face the risk of developing lesions on their feet. Lesions become infections that easily escalate and progress to amputations. A major contributing risk-factor is footwear that causes excessive shear and compression forces to occur on the weight-bearing foot.
For people with Diabetes,
One of seven will develop foot ulcers
One in five of them will need an amputation*
A primary strategy for protecting the feet of people with diabetes is to provide therapeutic footwear. Therapeutic shoes are professionally fitted to accommodate custom molded insoles, and provide a safe environment for the feet, especially in the toe area. Custom molded insoles evenly distribute pressures across the weight-bearing (plantar) surface of the foot.
* Pendsey, S. P. (2010). Understanding diabetic foot. International Journal of Diabetes in Developing Countries, 30(2), 75–79.
THERAPEUTIC SHOE BENEFIT (TSB)
In May 1993, Congress amended Medicare statutes to provide partial reimbursement for depth shoes, custom molded shoes, and shoe inserts or orthopedic modifications to qualifying Medicare Part B patients with diabetes. Most insurers and HMOs provide coverage for diabetic footwear.
In order to qualify, you must have a diagnosis of diabetes with at least one of the following conditions:
History of partial or complete amputation of the foot
History of previous foot ulceration
History of pre-ulcerative callus
Peripheral neuropathy with evidence of callus formation
WHY BOSTON PEDORTHIC FOR DIABETES?
At Boston Pedorthic your footwear is our “sole” concern. Pedorthists are clinically trained shoe specialists, knowledgeable in anatomy & physiology, lower-extremity biomechanics, and disorders affecting the feet and gait. What’s more, experienced pedorthists know shoe construction.
Whether it’s for casting and crafting a custom shoe, or cutting apart a shoe and building up an orthopedic modification, you can depend upon skilled hand work and expert decision-making.
Choose from a wide variety of styles in depth shoes.
Alden of New England
Tauer & Johnson
LOWER LIMB AMPUTATIONS DUE TO DIABETES
Centers for Disease Control and Prevention, National Center for Chronic Disease and Health Promotion. National Diabetes Fact Sheet: National estimates and general information on diabetes and prediabetes in the United States, 2011. Atlanta, GA: Centers for Disease Control & Prevention; 2011.
DECREASES IN LOWER-LIMB AMPUTATIONS IN MASSACHUSETTS
From 1997 to 2012, the number of lower-limb amputations in Massachusetts decreased 24.2 percent A total of 45,756 lower-limb amputation procedures were performed in the state of Massachusetts in these years. This represents 92.7 percent of all amputation procedures performed in the state.
From 1997 to 2012, 2,132,297 lower-limb amputations procedures were performed in the United States. The number of lower-limb amputation procedures performed in Massachusetts represents 2.1 percent of this national total.The leading causes of lower-limb amputation are complications resulting from dysvascular diseases such as diabetes, and the number of people who lose a limb due to diabetes is expected to almost triple by the year 2050.
(1) Ziegler-Graham K, MacKenzie EJ, Ephraim PL, Travison TG, Brookmeyer R. Estimating the prevalence of limb loss in the United States: 2005 to 2050. Archives of Physical Medicine and Rehabilitation2008;89(3):422-9.
(2) Dillingham TR. Limb amputation and limb deficiency: Epidemiology and recent trends in the United States. Southern Medical Journal2002;95(8):875-83.
WHO LOSES A LIMB IN MASSACHUSETTS (2012)
In 2012, most amputations in Massachusetts were performed on individuals aged 65-84 years old (43.8 percent) and those aged 45-64 years (38.8 percent) (see Graph 3.1). These trends largely reflect the aging population and causes of amputations resulting from dysvascular conditions, especially diabetes, which are more common in older individuals.
(1) 1. Ziegler-Graham K, MacKenzie EJ, Ephraim PL, Travison TG, Brookmeyer R. Estimating the prevalence of limb loss in the United States: 2005 to 2050. Archives of Physical Medicine and Rehabilitation2008;89(3):422-9.
NEWLY DIAGNOSED CASES OF DIABETES IN MASSACHUSETTS
Source: Centers for Disease Control