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.....Fax: .......919.876.4485
.....Address: 3430 Tarheel Drive,
...................Suite 104
...................Raleigh, NC 27609


 
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AMBULATORY AIDS
WALKERS
Indications and Limitations of Coverage and/or Medical Necessity
Documentation Requirements
CANES AND CRUTCHES
Indications and Limitations of Coverage and/or Medical Necessity

 

WALKERS

Indications and Limitations of Coverage and/or Medical Necessity

A standard walker (E0130, E0135, E0141, E0143) and related accessories are covered if both of the following criteria are met:

1) It is prescribed by a physician for a patient with a medical condition impairing ambulation and there is a potential for ambulation; and

2) There is a need for greater stability and security than provided by a cane or crutches.

A heavy duty walker (E0148, E0149) is covered for patients who meet coverage criteria for a standard walker and who weigh more than 300 pounds.

A heavy duty, multiple braking system, variable wheel resistance walker (E0147) is covered for patients who meet coverage criteria for a standard walker and who are unable to use a standard walker due to a severe neurologic disorder or other condition causing the restricted use of one hand. Obesity, by itself, is not a sufficient reason for an E0147 walker.

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Documentation Requirements

An order for each item billed must be signed and dated by the treating physician, kept on file by the supplier, and made available to the DMERC upon request.

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CANES AND CRUTCHES

Indications and Limitations of Coverage and/or Medical Necessity

Canes (E0100, E0105) and crutches (E0110 - E0116) are covered when prescribed by a physician for a patient with a condition causing impaired ambulation and there is a potential for ambulation.

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