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.
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Canes and Crutches Criteria

This 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