Please note that this criteria is taken and summarized directly from Noridian Medicare's LCD page. We try to keep this updated as possible. For the full article, please click here.
Canes and Crutches CriteriaThis criteria applies to all canes and crutches.
• The beneficiary has a mobility limitation that significantly impairs his/her ability to participate in one or more mobility-related activities of daily living (MRADL) in the home.
toileting, feeding, dressing, grooming, and bathing (at least one must be stated in the clinical documentation
A mobility limitation is one that:
Prevents the beneficiary from accomplishing the MRADL entirely; or,
Places the beneficiary at reasonably determined heightened risk of morbidity or mortality secondary
to the attempts to perform an MRADL; or,
Prevents the beneficiary from completing the MRADL within a reasonable time frame; and,
• The beneficiary is able to safely use the cane or crutch; and,
• The functional mobility deficit can be sufficiently resolved by use of a cane or crutch.
If patient requires a heavy duty cane or crutch, please list their height and weight on the prescription.
Prescription must also state:
Bariatric Cane or Bariatric Crutches