Important Notes on Medicare:
CMS National Coverage Determination 280.1
Continuous Passive Motion devices are devices Covered (sic) for patients who have received a total knee replacement. To qualify for coverage, use of the device must commence within 2 days following surgery. In addition, coverage is limited to that portion of the 3-week period following surgery during which the device is used in the patient’s home. There is insufficient evidence to justify coverage of these devices for longer periods of time or for other applications. Note that CMS has clarified to the DME MACs that in addition to a total knee replacement, a CPM device is also covered following the revision of a major component of a previous total knee replacement (i.e., tibial components or femoral component).
Additional billing instructions are provided in CMS Claim Processing Manual (Internet-only Publication 100-04) Chapter 20 Section 30.2.1 which states:
Contractors make payment for each day that the device is used in the patient’s home. No payment can be made for the device when the device is not used in the patient’s home or once the 21 day period has elapsed. Since it is possible for a patient to receive CPM services in their home on the date that they are discharged from the hospital, this date counts as the first day of the three-week limited coverage period.
Medicare Covers CPM Therapy. You have contributed to Medicare for years. You have choices about your Road to Recovery. You should DEMAND MOTION and request CPM therapy following your Total Knee Replacement!
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