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6 Tips on How Your Patients Can Protect Their Diabetic Feet

Thirty-four million Americans have diabetes. The disease will likely be a lifelong struggle for most of these people. While they may have to deal with it for the rest of their lives, they must remember that managing diabetes (and monitoring their foot health) is possible and encouraged.

Diabetic Foot

Read on to learn what your patients need to know in order to protect their diabetic feet.

Inspect Feet Daily

Your patients need to remember to check their feet every day for any changes that might occur. It’s important to monitor sores on the feet and look for signs of infection. Infections in diabetic people are complicated and prevention is key to staying healthy.

Patients need to look out for red areas, cracked skin or calluses, lesions, or any other changes occurring on the feet, especially between the toes.

Keep Feet Clean and Dry

Your patients need to wash their feet to keep them free of threads and fabrics that can cause friction or irritation. They shouldn’t soak their feet regularly because it can increase dryness.

Once clean, they need to dry their feet, especially between the toes. Diabetic feet are breeding grounds for fungus and bacteria when they aren’t kept dry.

Moisturizing is another task that needs to occur every night giving the feet plenty of time to soak up the cream and smooth out the skin.

Don’t Cut Your Own Toenails

Another common foot-related condition among diabetic patients is they may have thickened toenails, which can be difficult to cut. As a podiatrist, you are better equipped to handle that. By recommending that your patients come to you to get their toenails cut, you will be able to catch potential problems before they become an issue (like ingrown toenails!).

Remind them to leave callus removal to the professionals as well. Removing them with a sharp object can lead to infection while using OTC removers can burn the skin because they are usually made with some type of acid.

Monitor Your Blood Sugar Levels

High glucose can lead to neuropathy which can lead to loss of feeling in the feet. This occurs in approximately 70% of all diabetics. This loss of feeling is dangerous as it can lead to injury, infections, and even amputation.

Your patients can maintain a healthier blood glucose streak by eating well-balanced diets and monitoring blood sugar regularly.

Never Go Barefoot

Loss of feeling in the feet makes it a lot easier to suffer from an injury that causes damage to your patient’s feet. By wearing orthotic slippers or shoes with support, they reduce the chance of getting cuts, bruises, or broken bones when moving around their home. These problems might go undetected by a diabetic due to their awareness becoming hindered by neuropathy or loss of feeling in their feet.

Wear the Right Socks and Shoes

Wearing the right socks and shoes is essential for diabetics, especially those dealing with numbness.

There are certain types of shoes for diabetic feet that are made to prevent friction and irritation. They are generally soft, padded, and seamless. These shoes are deep enough for diabetic inserts and orthotics to be placed inside the shoe for maximum comfort.

Check our website for a list of diabetic shoes we have in stock.

The ideal socks for diabetics are going to be made out of fabric that is moisture-wicking such as natural wool or bamboo. They are going to fit snugly on the feet and legs without adding extra pressure on the skin. Ideally, you should have your patients look for socks with copper-infused yarn as well as moisture-wicking properties for added protection and anti-fungal benefits. Check out our line of Diabetic Copper Cloud Socks on our website.

Caring for Diabetic Feet

Caring for diabetic feet isn’t easy, but it will make a world of difference in a diabetic’s overall health and well-being. It’s important that, as their medical clinician, you are relaying essential information to your patients to help them maintain healthy feet.

Contact SafeStep today for more information on our patient evaluation processes and how our products promote diabetic foot care.

Understanding the Difference Between Diabetic and Regular Footwear

Diabetic Footwear helps prevent the continued wear of the feet and helps to decelerate the breakdown of the plantar fascia. You may be wondering, what is diabetic footwear?

This article will help you understand what diabetic footwear is and how it differs from regular footwear.

What is Diabetic Footwear? 

Diabetes causes various health and physical ailments to those who suffer from it. One of the primary side effects of diabetes is moderate to severe nerve damage.

Diabetics often experience and suffer from nerve damage to their feet. This causes them to lose feeling as well as lose blood flow to their feet.


This condition is known as peripheral or diabetic neuropathy. This condition starts relatively mild at first but can progressively get worse. This could later develop into ulcers and varicose veins.

To prevent these things from occurring, Diabetics must take preventative action by extra good care of their feet. This begins with proper diabetic socks and special orthopedic footwear.

How Does it Differ From Regular Footwear?

Diabetic footwear is specially designed to assist with blood flow to the feet. It also helps protect the foot against injuries to the toes and the bottom of the foot.

Diabetic footwear is often paired with specialized orthotic inserts to protect against sores and provide arch support, heel support, and metatarsal support where needed.

Normal shoes do not protect against sores and damage to the extremities. The best diabetic footwear provides both protection and support. Normal footwear only provides minimal protection from the elements and is a device used to separate the foot from the ground.

You can increase protection and comfort by prescribing and recommending diabetic inserts and diabetic shoes for your patients.

What Shoes Are Best For Diabetics? 

Diabetic shoes should not be bulky or restrictive. Diabetics need to have plenty of room for their feet to move and breathe, including a high and wide toe box, as well as adjustable closure options to accommodate edema.

The best shoes are lightweight and have superior stability. They should have substantial midsole/outsoles to protect your patients’ feet from the uneven surfaces they walk on, and ideally be slip-resistant, too.

Selecting Your Diabetic Footwear

There are generally two categories of diabetic shoes. These include walking shoes and casual shoes.

Walking shoes resemble an athletic sneaker, and should have a high and wide toe box, be available in multiple widths, and have removable spacers or depth to accommodate inserts and provide a superior fit. They should also have a very rigid sole and a reinforced heel counter.

Casual shoes may resemble shoes like men’s or women’s dress styles, boat shoes, or casual or closed-toe sandals. When selecting a casual shoe, you will want to look for many of the features listed for the walking style and look for a footwear provider that specializes in diabetic or orthopedic footwear, such as SafeStep.

The best shoes for diabetic patients should have breathable uppers, and superior motion control and support. Support is not a common feature in most shoes, therefore it is paramount that you look for specific orthopedic/therapeutic footwear brands.

As a general rule of thumb, Diabetics should avoid high-heeled shoes, most sandals, and open-toed shoes as most of these styles do not provide proper support and may restrict blood flow and edema.

Get Your Diabetic Footwear Today

diabetic footwear

Diabetic footwear is an essential part of every diabetic’s preventative care routine. Foot care helps prevent serious issues that can lead to serious health conditions including surgery or amputation.

Fortunately, our staff at SafeStep has a variety of footwear options for your needs. We have an extensive catalog available on our website.  Contact us today with any questions or concerns you may have.

Diabetic Socks: Everything You Need to Know

Every 1 in 10 people is suffering from diabetes. This means every person with this health condition needs to worry about what they eat, drink, and most importantly what they wear on their feet.

It can be easy for Diabetic patients to overlook the importance of footwear, but we need to remind them that it should be a daily priority.
Before the footwear comes socks, diabetic patients need to know what types of socks they should and should not be wearing.

This article will give you all the answers to the question, “What are diabetic socks?” and points you in the right direction for diabetic footwear so you can pass on the information to your patients.

What Are Diabetic Socks?

Copper Cloud Socks

First, let’s cover the basics…

Diabetic socks are specially designed to reduce one’s risk of a foot injury, improve blood circulation, help prevent bacteria formation and make sure the feet stay dry. Diabetic Socks could be a life-changing addition to your patients’ lives.

But, how do they differ from regular socks?

1. Circulation

It is common for people suffering from diabetes to have problems with their feet that can lead to swelling and loss of nerve damage. The scientific name for this is neuropathy.

By removing the elastic that puts pressure on your feet from regular socks, diabetic socks allow blood to flow and help prevent the risks associated with socks that do not accommodate edema.

2. Rubbing

Diabetic patients are at higher risk of having foot complications like sores, open wounds, and blisters. Socks with too much compression or that are too tight will cause rubbing and exacerbate these issues.

Diabetic socks ease the tension and provide a more comfortable fit so you don’t have to experience the constant rubbing that is associated with normal socks.

Additionally, diabetic socks may be infused with Copper yarn, which has natural antimicrobial, anti-fungal, and anti-odor properties that help keep the feet in a clean environment and leaves skin softer.

3. Sweat Reduction

It is also important for patients to keep their feet dry. Why? Because sweat that festers for too long can cause infections and sores.

The best diabetic socks keep your feet dry and cozy. The ideal combination. Most diabetic socks have moisture-wicking properties that help keep the feet dry. Additionally, some socks may be specifically ventilated to promote temperature control and airflow.

It’s important to provide your patients with everything they need to manage their condition and get the best out of their daily lives. Helping prevent feet issues with the proper diabetic socks is a great start.

Other Ways to Support Diabetic Feet

You can never have too much foot support. Make sure you pair diabetic socks with proper diabetic footwear for your patients.

Here is a list of features you will want to look for when recommending diabetic footwear to your patients:

  • Protective interior lining
  • Stretchable uppers
  • Firm Heel Counter
  • Stable midsole/outsole
  • Extra-depth to accommodate orthotic inserts
  • High and wide toe box
  • Adaptable closure

Copper Cloud Socks

The next time your patient asks about ways to support their feet you can suggest diabetic socks, diabetic footwear, as well as supportive inserts. You can find all of your diabetic footwear needs by visiting the SafeStep website!

Medicare DME Reimbursement Increases in 2022

2022 Updated reimbursements:

Depth Shoes (A5500): pair $186.72 (Ceiling)
Prefabricated, Heat Molded Inserts (A5512): pair $76.16 (Ceiling)
Custom Milled Inserts (A5514): pair $113.64 (Ceiling)
Depth Shoes w/3 pr. Prefab, Heat Molded Inserts: $415.20 (Ceiling)
Depth Shoes w/3 pr. Custom Milled Inserts: $527.64 (Ceiling)
Custom Molded Shoes (A5501): $560.00 (Ceiling)
Arizona AFO, Standard (L1940, L2330, L2820): each – Ceiling $1281.17, Floor $960.88
Arizona Balance Brace (L1940, L2330, L2820): pair – Ceiling $2562.34, Floor $1921.76

Medicare DME Reimbursement Increases in 2020

Good news!

On January 1, 2020, Medicare increased the amount it pays for diabetic shoes, Moore Balance Brace and Arizona custom AFOs.

While the amounts paid may vary slightly by state, the National Fee Schedule is as follows:

Depth Shoes (A5500): pair $147.74
Prefabricated, Heat Molded Inserts (A5512): pair $60.26
Custom Milled Inserts (A5514): pair $89.92

Depth Shoes w/3 pr. Prefab, Heat Molded Inserts: $328.52
Depth Shoes w/3 pr. Custom Molded Inserts: $417.50

Custom Molded Shoes w/offset heels and rocker bottoms: $585.26

Arizona AFO, Standard (L1940, L2330, L2820): each – Ceiling $1216.57, Floor $912.42
Moore Balance Brace (L1940, L2330, L2820): pair – Ceiling $2433.14, Floor $1824.84

For a complete listing of updated DME allowables, including prefabricated and custom ankle-foot orthoses, visit:

Medicare DME Supplier Enrollment Now Easiest If Done Online!

The Internet-based PECOS (Provider Enrollment, Chain and Ownership System) can be used in lieu of the Medicare enrollment application (i.e., paper CMS-855) to:

  • Submit an initial Medicare enrollment application
  • View or change your enrollment information
  • Track your enrollment application through the web submission process
  • Add or change a reassignment of benefits
  • Submit changes to existing Medicare enrollment information
  • Reactivate an existing enrollment record
  • Withdraw from the Medicare Program
  • Submit a Change of Ownership (CHOW) of the Medicare-enrolled provider

Advantages of Internet-based PECOS

  • Faster than paper-based enrollment (45 day processing time in most cases, vs. 60 days for paper)
  • Easy to check and update your information for accuracy
  • Less staff time and administrative costs to complete and submit enrollment to Medicare

Using Internet-based PECOS Is Easy!

Before initiating an enrollment action using Internet-based PECOS, you should review the applicable “Basics of Internet-based Provider Enrollment, Chain and Ownership System (PECOS)” Fact Sheet(s) and “Enrolllment Example” below.


Physicians and non-physician practitioners may access Internet-based PECOS by using the User IDs and passwords that they established when they applied on-line to the National Plan and Provider Enumeration System (NPPES) for their National Provider Identifiers (NPIs).   If you have forgotten your User IDs or passwords, or otherwise need assistance in this regard, contact the NPI Enumerator at 1-800-465-3203 or

  1. Log onto Internet-based PECOS with your NPPES User ID and password.
  2. Complete, review, and submit an electronic enrollment application. Internet-based PECOS will walk you through the application process and supply you with a 2-page Certification Statement for each enrollment application you submit.
  3. Mail the original signed Certification Statement from Internet-based PECOS and supporting documents to the Medicare contractor within 15 days of your electronic submission.


Correct Coding – RT and LT Modifier

Until now, suppliers billing for bilateral DME devices including therapeutic shoes for patients with diabetes, diabetic inserts, custom AFOs or custom foot orthoses, have been able to submit electronic claims by indicating the total quantity and using the RTLT modifier on a single line OR by using RT on one line and LT on another, noting half the quantity on each.

Beginning March 1, 2019, such claims MUST be submitted using two separate lines, using the RT and LT modifier on each. Units of service (UOS) should be “1″ on each line for shoes and for AFOs; it should be up to “3″ on each line, for prefabricated or custom diabetic inserts. Claim lines for HCPCS codes requiring use of the RT and LT modifiers, billed without the RT and / or LT modifier or with RTLT on a single claim line, will be rejected as incorrect coding.

Suppliers who have been submitting codes for bilateral devices using one line are advised to start billing on two separate lines NOW and not wait until March 1.

As always, each claim line should also include the modifier KX to indicate that all required compliance documentation is on file. When billing L3000 for custom foot orthotic devices, the GY modifier should be used to indicate that the item is statutorily excluded and cause the claim to deny.

For a link to the Medicare carrier website and Policy Articles, see:

Helpful Links Using the Medicare DME Portals

Each of the DME MACs have created webpages that offer podiatrists and other DME suppliers access to useful Medicare information.  The “Portals” requires individual registration and uses a personal log-in.  They offer different levels of accessibility and also protects patient personal health information.  Presently Jurisdictions A and D are serviced by Noridian; Jurisdictions B and C are serviced by CGS.

Podiatrists are encouraged to register for the Portals corresponding to the region(s) where their patients reside and to also create access for appropriate staff members.  Some of the things that are certain to prove useful include: Medicare Beneficiary Identifier (MBI) lookup,  info about the Interactive Voice Response (IVR) for checking status of claims, and redetermination.


Noridian Medicare Portal (NMP)

Jurisdiction A, Jurisdiction D.

CGS Medicare Portal (myCGS)

Jurisdiction B, Jurisdiction C.


Medicare Beneficiary Identifier (MBI) Look Up Tool

A new Medicare Beneficiary Identifier (MBI) replaced the SSN-based Health Insurance Claim Number (HICN) on the new Medicare cards for Medicare transactions like billing, eligibility status, and claim status.

In the past, the HICN was based on a person’s social security number.  Every person with Medicare has been assigned an MBI and has been mailed a new Medicare card.  The MBI is confidential like the SSN and should be protected as Personally Identifiable Information.  The biggest reason for the new MBI is to fight medical identity theft for people with Medicare.

The MBI provides podiatrists and other DME suppliers information need to enter using the telephone key pad when using the IVR and is based only on the information you enter. 

Use this tool to convert the patient’s MBI to the corresponding numbers on your telephone key pad. Medicare Beneficiary Identifier (MBI) Lookup Tool is an option for providers/suppliers if they are not able to obtain the MBI from the patient.

Noridian DME: Jurisdiction A, D

CGS: Jurisdiction B, C


Medicare Interactive Voice Response (IVR)

The Centers for Medicare & Medicaid Services (CMS) requires providers to utilize the Interactive Voice Response (IVR) System to check the status of claims.  The Interactive Voice Response (IVR) system requires you to enter your patient’s name and Medicare number during the beneficiary validation process.   The IVR will validate the beneficiary information.


Noridian: Jurisdictions A, D

CGS: Jurisdictions B, C

To use the IVR, please call: 877.299.7900


Submitting Redeterminations Through the Medicare Portal

When AFO claims are denied and given reason code “M3”, it’s because of “Same or similar”, meaning that Medicare is only covering one device, prefabricated or custom, per side, every five years.  Claims to treat a different diagnosis with a different device, can generally be covered, even after initial denial, if appealed as a “Redetermination”.  Redetermination can be done either by faxing in a form and supporting documentation or via the Portal.  Its recommended that suppliers use the Portal, and not fax, as it provides assurance that all forms are received.  


Noridian: Jurisdictions A, D

CGS: Jurisdictions B, C


Documentation Identification Tool

CGS has created the Documentation Identification Tool to assist you in submitting the different types of documentation needed to support your claim. Simply select the type of documentation you are submitting from our list of items below. Then print the pre-designed divider sheet and place it in front of the document(s) that will be submitted for review.

The documentation identification tool standardizes the process so you no longer need to create your own divider sheets for your documentation.


Jurisdiction A is serviced by Noridian Healthcare Solutions   and includes Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island and Vermont.

Jurisdiction B is serviced by CGS   and includes Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio and Wisconsin.

Jurisdiction C is serviced by CGS   and includes Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, Virginia, West Virginia and the US Virgin Islands.

Jurisdiction D is serviced by Noridian Healthcare Solutions   and includes Alaska, American Samoa, Arizona, California, Guam, Hawaii, Idaho, Iowa, Kansas, Missouri, Montana, Nebraska, Nevada, North Dakota, Northern Mariana Islands, Oregon, South Dakota, Utah, Washington and Wyoming,


Medicare DME Reimbursement Increases in 2019

Good news!
On January 1, 2019, Medicare increased the amount it pays for diabetic shoes, Moore Balance Brace and Arizona custom AFOs.

While the amounts paid may vary slightly by state, the National Fee Schedule is as follows:
Depth Shoes (A5500): pair $146.42
Prefabricated, Heat Molded Inserts (A5512): pair $59.72
Custom Milled Inserts (A5514): pair $89.12
Depth Shoes w/3 pr. Prefab, Heat Molded Inserts: $325.36
Depth Shoes w/3 pr. Custom Molded Inserts: $413.78
Custom Molded Shoes w/offset heels and rocker bottoms: $656.62
Arizona AFO, Standard (L1940, L2330, L2820): each – Ceiling $1178.61, Floor $904.29
Moore Balance Brace (L1940, L2330, L2820): pair – Ceiling $2357.22, Floor $1808.58

For a complete listing of updated DME allowables, including prefabricated and custom ankle-foot orthoses, visit:

AFO Custom Diabetic Insert Alert


Medicare is now differentiating between custom diabetic inserts fabricated by direct milling and those made by custom molding. Medicare requires that custom diabetic inserts made by CAD / CAM direct milling be billed using new code A5514 when dispensed, replacing K0903, effective January 1, 2019. Inserts provided by SafeStep are made in this way. If SafeStep does your billing, everything will be taken care of for you. If you submit claims yourself or via a billing service, be sure to start using the new custom insert code, A5514.

Both methods of manufacturing result in equivalent final products; reimbursement is also the same, $89.12 per pair, $267.36 for three pairs. Medicare is requiring manufacturers to submit custom diabetic inserts to PDAC for verification and has communicated that custom inserts need not be listed on the PDAC website,

If you have any questions, concerns or suggestions, please call our office at 866.712.STEP.