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Limitations on Podiatric Services

Illinois Medicaid - HFS·IL · Podiatry·Provider Notice
Effective date
Jul 1, 2012
We identified it
Jun 20, 2026
Days to comply

Summary

Effective July 1, 2012, podiatric services for patients 21 and older are now limited to diabetes-related foot/ankle conditions only. Claims must include a primary diabetes diagnosis (ICD-9 250.xx range) and secondary diagnosis for the diabetic complication, or they will be rejected with error code G51.

Action Required

Action needed
Immediately: Billing team must update system to require primary diabetes diagnosis (ICD-9 250.xx) and secondary diabetic complication diagnosis for all podiatric services billed for patients 21 and older. Update encounter forms to remind providers of diagnosis requirements. Review July 1, 2012 Podiatric Fee Schedule on department website for specific payable procedure codes. Claims without proper diabetes diagnosis will reject with error code G51.