Current Pedorthics | January-February 2016 | Vol.48, Issue 1 | Page 44

STANDARDS, SPECIFIC DETAILS & JEOPARDY ing portions of the foot, including the arch throughout the standing and walking phases of gait.” The foot is flexible as is the shoe, Total contact is a physical impossibility in a removable shoe. Conformed by directly molding to the patient's foot? With present day technology how can this be done without exposing a patient to harm? The same code goes on to specify, “The insert must retain its shape during use for the life of the insert (How long will that be?). The layer responsible for shape retention is called the ‘base layer’ in the code descriptor (How would one define that?). This material usually constitutes the bottom layer of the device and must be of a sufficient thickness for the base to maintain its shape during use (i.e., at least 1/4 inch of 35 Shore A or higher or at least 3/16 inch of 40 Shore A or higher).” Flexible and bendable products by definition do not retain their shapes. The material responsible for maintaining the shape of the device must be heat moldable? ls it obvious that many undefined points of performance, construction, quality, dimension and longevity are generated from A5512, without adequate specificity? Specifying a Shore A designation is as close "Where does this leave the producer of footwear products specified by the Medicare directives?" 42 Pedorthic Footcare Association www.pedorthics.org Photo from: @Shutterstock.com/Robert Przybysz "Question, where does directive A37076 demonstrate value as a quality performance standard for therapeutic footwear?"