Podiatry services are medically necessary foot care including:
- Cutting or removal of corns and calluses
- Trimming, cutting, clipping or debriding of nails
- Other hygienic care due to a physical or clinical finding that is consistent with a metabolic, neurological, and peripheral vascular disease diagnosis and indicative of severe peripheral involvement
When these services are not medically necessary, they are considered routine and are not covered by the NC Medicaid program.
Podiatry and medically necessary routine foot care services do not require prior approval (PA) except for women enrolled in the Medicaid for Pregnant Women (MPW) program. The PA for MPW enrollees is required to document medical necessity for services related to pregnancy or due to complications of pregnancy. See Clinical Coverage Policy 1C-1 and 1C-2, Section 5.1.
To obtain prior approval for the above circumstances, call NCTracks at 800-688-6696.
Medical Assistance Clinical Section