COF COF Diabetic & Therapeutic Footwear 4

Question 1

Under the Medicare Therapeutic Shoe Bill (Section 4572), how many pairs of depth-inlay shoes per calendar year is a qualifying diabetic patient entitled to?

Accepted Answer

One pair

Answer

Medicare covers one pair of depth-inlay shoes (or one pair of custom-molded shoes) per calendar year for qualifying diabetic beneficiaries.

Question 2

Which Medicare documentation requirement must a certifying physician complete before a patient can receive therapeutic footwear?

Accepted Answer

Certificate of Medical Necessity (CMN)

Answer

A Certificate of Medical Necessity signed by the certifying physician is required to qualify the patient for the Medicare therapeutic shoe benefit.

Question 3

A patient with diabetes presents with a healed plantar ulcer at the first metatarsal head. Which shoe modification best offloads this high-pressure area?

Accepted Answer

Metatarsal bar applied externally to the outsole

Answer

An external metatarsal bar transfers pressure proximal to the metatarsal heads, directly offloading a healed plantar ulcer at that site.

Question 4

When fitting diabetic footwear, what minimum toe box depth is recommended to prevent dorsal toe pressure in patients with hammertoes?

Accepted Answer

At least 1/2 inch of clearance above the longest toe

Answer

A minimum of 1/2 inch (approximately 1.25 cm) of vertical clearance above the longest toe prevents dorsal pressure on hammertoe deformities.

Question 5

Which insole material is most appropriate as the top cover for a diabetic patient with peripheral neuropathy to minimize shear forces?

Accepted Answer

Plastazote (closed-cell polyethylene foam)

Answer

Plastazote is preferred as a top cover in diabetic insoles because it molds to foot contours and reduces shear and pressure in insensate feet.

(COF) Certified Orthotic Fitter Practice Test

(COF) Certified Orthotic Fitter Practice Test

COF COF Diabetic & Therapeutic Footwear 4