Section 405IAC5-26-5. Prior authorization

   (a) Prior authorization by the office is required for the following:

(1) Hospital stays as outlined in 405 IAC 5-17.

(2) When a podiatrist prescribes or supplies corrective features built into shoes, such as heels, lifts, and wedges, for a member under twenty-one (21) years of age.

(3) When a podiatrist fits or supplies orthopedic shoes for a member with severe diabetic foot disease subject to the restrictions and limitations outlined 405 IAC 5-19.

  (b) Medicaid reimbursement is available for the following surgical procedures without prior authorization:

(1) Surgical cleansing of the skin.

(2) Drainage of skin abscesses.

(3) Drainage or injections of a joint or bursa.

(4) Trimming of skin lesions.

Reimbursement for other surgical procedures performed within the scope of the podiatrist's license is available subject to the prior authorization requirements of 405 IAC 5-3. (Office of the Secretary of Family and Social Services; 405 IAC 5-26-5; filed Jul 25, 1997, 4:00 p.m.: 20 IR 3349; readopted filed Jun 27, 2001, 9:40 a.m.: 24 IR 3822; filed Feb 14, 2005, 10:25 a.m.: 28 IR 2134; readopted filed Sep 19, 2007, 12:16 p.m.: 20071010-IR-405070311RFA; readopted filed Oct 28, 2013, 3:18 p.m.: 20131127-IR-405130241RFA; filed Aug 1, 2016, 3:44 p.m.: 20160831-IR-405150418FRA)