COF Diabetic & Therapeutic Footwear Flashcards

Charcot neuroarthropathy most commonly affects which joint in the foot?

Answer: Lisfranc (tarsometatarsal) joint complex

Charcot neuroarthropathy most frequently affects the midfoot at the Lisfranc tarsometatarsal joint complex, causing the characteristic rocker-bottom deformity.

When managing a patient with acute phase Charcot foot, the most appropriate orthotic intervention is:

Answer: Total contact cast or Charcot Restraint Orthotic Walker (CROW)

A total contact cast or CROW boot immobilizes the foot and distributes pressure to allow the Charcot inflammatory process to stabilize before custom orthotic fitting.

Which shoe last shape is most appropriate for a patient with hallux valgus (bunion)?

Answer: Straight or wide toe box last

A straight or wide toe box last accommodates the medial prominence of hallux valgus without creating pressure over the bunion.

A patient with severe peripheral arterial disease requires therapeutic footwear. What is the most important initial consideration?

Answer: Vascular assessment and possible referral before orthotic intervention

Severe PAD compromises tissue oxygenation; any additional pressure from orthotics can cause ischemic ulceration, so vascular assessment and potential intervention must precede fitting.

What is the function of a steel shank in therapeutic footwear?

Answer: Limit forefoot flexion and reduce stress on the metatarsals during propulsion

A steel shank embedded in the midsole limits forefoot flexion, reducing stress on the metatarsals and toe joints during the propulsive phase of gait.

Which HCPCS code range specifically covers custom-molded diabetic shoes and inserts under Medicare?

Answer: A5500–A5513

HCPCS codes A5500–A5513 specifically cover diabetic shoes and custom inserts under the Medicare Therapeutic Shoe Bill.