A5501

For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patient’s foot (custom molded shoe), per shoe

Short Description: Diabetic custom molded shoe

Coverage Code: Special coverage instructions apply

Action Code: No maintenance for this code

Date Added: January 1, 1995

Effective Date: January 1, 2005

Termination Date:

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