Medical Necessity For Afo

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Ankle-Foot/Knee-Ankle-Foot Orthoses - Policy Article

https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=52457

non-medical necessity coverage and payment rules For any item to be covered by Medicare, it must 1) be eligible for a defined Medicare benefit category, 2) be reasonable and necessary for the diagnosis or treatment of illness or injury or to …

Ankle Orthoses, Ankle-Foot Orthoses (AFOs), and Knee …

https://www.aetna.com/cpb/medical/data/500_599/0565.html

AFOs are not considered medically necessary for ambulatory members who do not meet these medical necessity criteria. Aetna's HMO plans do not consider AFOs and any …

CG-DME-22 Ankle-Foot & Knee-Ankle-Foot Orthoses

https://www.anthem.com/dam/medpolicies/abc/active/guidelines/gl_pw_a053659.html

An ankle-foot orthosis (AFO) is considered medically necessary for ambulatory (i.e., able to walk, independently or with assistance) individuals with …

LCD - Ankle-Foot/Knee-Ankle-Foot Orthosis (L33686)

https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33686&DocID=L33686

Coverage Indications, Limitations, and/or Medical Necessity For any item to be covered by Medicare, it must 1) be eligible for a defined Medicare benefit category, 2) …

Documentation Checklist for Ankle-Foot/Knee-Ankle-Foot …

https://med.noridianmedicare.com/documents/2230715/26734435/Documentation+Checklist+-+Ankle-Foot+Knee-Ankle-Foot+Orthoses

Medical records document the basic coverage criteria: Beneficiary is ambulatory; and. Has a weakness or deformity of the foot and ankle; and. Requires …

Document of Medical Necessity for AFO (Molded to Patient …

http://www.apmacodingrc.org/pdf/DocOfMedNecessityAFO.pdf

1. The patient could not be fitted with a prefabricated AFO 2. The condition necessitating the orthoses is expected to be permanent of longstanding duration …

Ankle-Foot (AFO)/Knee-Ankle-Foot (KAFO)/Hip …

https://www.modahealth.com/pdfs/med_criteria/AFO-KAFO-HKAFO.pdf

AFOs and KAFOs that are custom-fabricated are considered medically necessary when ALL of the following criteria are met Functional deficit of the knee, as indicated by 1 or more of …

Letter of Medical Necessity (Sample for most commonly …

https://pinnaclepa.com/wp-content/uploads/2017/05/Letter-of-Medical-Necessity-DME.pdf

Duration of Treatment/Medical Necessity for pre-fabricated device: This Pre-fabricated AFO is appropriate to treat patient ____________’s condition as he/she suffers with …

Foot Orthotics - Medical Clinical Policy Bulletins | Aetna

https://www.aetna.com/cpb/medical/data/400_499/0451.html

Custom-made orthopedic shoes are considered medically necessary when the severity of the foot condition is such that a lesser means, for example, inlay shoes, shoe …

Orthotic Devices and Shoes - Cigna

https://static.cigna.com/assets/chcp/pdf/coveragePolicies/medical/mm_0543_coveragepositioncriteria_orthotic_devices_shoes.pdf

meets the above medical necessity criteria for an AFO or KAFO is considered medically necessary when ANY of the following criteria applies: The individual cannot be fitted …

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