19" The areas must be tested randomly since the loss of protective sensation may be patchy in distribution, and the patient may get clues if the test is done rhythmically. Five sites should be tested on the plantar surface of each foot, 18 using the guidelines in the National Institute of Diabetes and Digestive and Kidney Diseases publication "Feet Can Last a Lifetime. LOPS shall be diagnosed through sensory testing with the 5.07 monofilament. Other causes of peripheral neuropathy should be considered and investigated by the primary care physician prior to initiating scheduled foot care for persons with LOPS. The diagnosis of peripheral neuropathy with LOPS due to diabetes mellitus should be established and documented prior to coverage of foot care. This decision memorandum announces the agency's intention to issue a National Coverage Decision covering foot care, that would otherwise be considered routine in the absence of localized illness of the feet, for Medicare beneficiaries with peripheral neuropathy with LOPS as provided or under 42 C.F.R.
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