Diabetic Neuropathy Foot Screening 2026 | DPM

Quick answer: Diabetic Peripheral Neuropathy Foot Screening Annual Exam Michigan is a common foot/ankle topic that affects many patients. Effective treatment starts with a targeted diagnosis, conservative-first treatment, and escalation only when needed. We treat this regularly at our Howell and Bloomfield Hills practices. Call (810) 206-1402.

Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

Why the Annual Diabetic Foot Exam Is the Highest-Value Podiatry Visit

The annual diabetic foot examination is the single highest-value podiatric intervention available — not because it is technically complex, but because it identifies the conditions that lead to the 100,000+ lower extremity amputations performed annually in the United States, most of which are preventable with early identification and intervention. The pathological chain: peripheral neuropathy causes loss of protective sensation; undetected wounds from loss of sensation progress to infected ulcers; infected ulcers with inadequate vascular supply develop gangrene; gangrene leads to amputation. The annual foot exam identifies where each diabetic patient is on this chain and intervenes appropriately. At Balance Foot & Ankle in Howell and Bloomfield Hills, Michigan, Dr. Tom Biernacki, DPM performs comprehensive diabetic foot examinations covered by Medicare and most insurers. Call (810) 206-1402.

What the Diabetic Foot Examination Includes

The comprehensive diabetic foot exam at Balance Foot & Ankle evaluates six domains: neuropathy assessment — 10-gram Semmes-Weinstein monofilament applied to nine plantar sites; loss of protective sensation at two or more sites indicates high ulceration risk; 128Hz tuning fork vibratory threshold at the hallux provides quantitative neuropathy grading; vascular assessment — dorsalis pedis and posterior tibial artery palpation; ankle-brachial index (ABI) measurement when pulses are diminished; skin and soft tissue assessment — callus formation at pressure sites (indicating ulceration risk), interdigital maceration (fungal infection and skin breakdown risk), and any active skin breakdown or pre-ulcerative lesions; deformity assessment — hammer toes, Charcot deformity, equinus contracture that increase ulceration risk; footwear assessment — identification of ill-fitting shoes with inadequate depth or width causing pressure points; and nail assessment — onychomycosis, onychogryphosis, subungual debris, and ingrown nail edges that can penetrate skin in neuropathic patients.

Risk Stratification — Who Needs What Follow-Up Interval

Diabetic foot risk stratification determines follow-up frequency: Low risk (intact sensation, intact vascularity, no deformity, no prior ulcer) — annual examination; Moderate risk (neuropathy OR peripheral arterial disease, but not both; no deformity; no prior ulcer) — every 3–6 months; High risk (neuropathy AND peripheral arterial disease; OR foot deformity; OR prior ulcer or amputation) — every 1–3 months; Active ulcer or wound — weekly to biweekly until healed. High-risk patients who are followed annually because they’re “doing well” are at preventable risk — the Medicare annual exam benefit does not prevent clinically indicated more-frequent visits.

Medicare Coverage for Diabetic Foot Services

Medicare Part B covers diabetic foot care services that most patients are unaware of: annual comprehensive foot examination for all Medicare beneficiaries with diabetes — $0 copay when the provider has accepted assignment; routine foot care (nail trimming, callus debridement) every 61 days for patients with documented diabetic peripheral neuropathy and resulting loss of protective sensation — covered when billed by a podiatrist with the appropriate diagnosis codes; custom-molded diabetic shoes and inserts — one pair of depth-inlay shoes and three pairs of custom inserts per calendar year under the Therapeutic Shoes for Persons with Diabetes benefit (requires a prescribing physician and fitting by a qualified podiatrist). Many diabetic patients pay out of pocket for services that are fully covered — calling Balance Foot & Ankle to verify coverage before your first visit prevents unexpected billing.

Diabetic Foot Screening in Howell & Bloomfield Hills Michigan

Dr. Tom Biernacki, DPM performs comprehensive diabetic foot examinations with monofilament neuropathy testing, vascular assessment, and Medicare-covered diabetic footwear prescription at Balance Foot & Ankle. Any Michigan diabetic patient who has not had a foot examination in the past year is encouraged to schedule — the exam takes approximately 30 minutes and is covered by Medicare and most commercial insurers. Serving Howell, Brighton, Grand Rapids, Bloomfield Hills, and all Southeast Michigan. Book your exam or call (810) 206-1402.

In-Office Treatment at Balance Foot & Ankle

If home treatment isn’t providing relief for your neuropathy, our podiatry team at Balance Foot & Ankle can help with same-day evaluations and advanced in-office care.

Frequently Asked Questions

When should I see a podiatrist?

If symptoms persist past 2 weeks, affect your normal activity, or are accompanied by red-flag symptoms (warmth, redness, swelling, inability to bear weight).

What does treatment cost?

Most diagnostic visits and conservative treatments are covered by Medicare and major insurers. Out-of-pocket costs vary by your specific plan.

How quickly can I get an appointment?

Most non-urgent cases see us within 5 business days. Urgent cases (sudden pain, possible fracture) typically same or next business day.