ARSD 67:16:07:04. Services not covered

The following podiatry services are not covered under the medical assistance program: (1) Stock orthopedic shoes, unless covered under chapter 67:16:11 for children less than twenty-one years of age, or built into a leg brace; (2) The treatment of flatfoot; (3) Surgical or nonsurgical treatment of subluxations of the foot, undertaken for the sole purpose of correcting a subluxated structure in the foot as an isolated entity, but not including: (a) Surgical correction of a subluxated foot structure that is an integral part of the treatment of a foot injury; or (b) Surgical correction of a subluxated foot structure that is undertaken to improve the function of the foot or to alleviate an inducted or associated symptomatic condition; (4) Routine foot care, unless infected or eczematized, or the individual has been diagnosed with metabolic, neurologic, or peripheral vascular disease: (a) Cutting or removing corns or calluses; (b) Trimming nails; (c) Hygienic and preventive maintenance care; (d) Using skin creams to maintain the skin tone of ambulatory and bedfast patients; and (e) The provision of services in the absence of localized illness, injury, or symptoms involving the foot; and (5) Treatment of a fungal infection of the toenail, unless there is clinical evidence of mycosis of the toenail and medical evidence documenting that: (a) The patient has a marked limitation of ambulation requiring active treatment of the foot; or (b) The patient is nonambulatory and has a condition that is likely to result in significant medical complication in the absence of treatment.