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Ambulatory Assist Devices: Walkers, Canes, and Crutches
Number: 0505
Policy *Please see amendment for Pennsylvania Medicaid at
the end of this CPB.
Canes and Crutches
Aetna considers canes, quad canes, and crutches medically
necessary durable medical equipment (DME) if all of the
following criteria are met:
I. The member 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. The MRADLs to be considered in this and all
other statements in this policy are toileting, feeding,
dressing, grooming, and bathing performed in
customary locations in the home. A mobility limitation is
one that:
A. Prevents the member from accomplishing the
MRADL entirely; or
Policy History
Last Review
10/10/2018
Effective: 06/12/2001
Next
Review: 05/09/2019
Review History
Definitions
Additional Information
Clinical Policy
Bulletin Notes
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B. Places the member at reasonably determined
heightened risk of morbidity or mortality secondary
to the attempts to perform an MRADL; or
C. Prevents the member from completing the MRADL
within a reasonable time frame; and
II. The member is able to safely use the cane or crutch;
and
III. The functional mobility deficit can be sufficiently
resolved by use of a cane or crutch.
Consistent with Medicare policy, Aetna does not consider
axillary (under-arm), articulated, spring-assisted crutches
medically necessary because the clinical value of these
specialized crutches have not been established. An axillary
(under-arm), articulated, spring-assisted crutch describes an
articulating crutch which has two crutch legs connected by a
bar between them which helps propel the member forward.
Aetna does not consider a sit-and-stand walking assistant type
crutch medically necessary because its clinical value has not
been established.
Note: Canes or crutches which contain a spring that reduces
impact and vibration against the ground should be coded with
the existing codes for canes or crutches.
Standard Walkers
Aetna considers a standard walker and related accessories
medically necessary DME if all of the following criteria are met:
I. The member 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. A mobility limitation is one that:
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A. Prevents the member from accomplishing the
MRADL entirely, or
B. Places the member at reasonably determined
heightened risk of morbidity or mortality secondary
to the attempts to perform the MRADL, or
C. Prevents the member from completing the MRADL
within a reasonable time frame; and
II. The member is able to safely use the walker; and
III. The functional mobility deficit can be sufficiently
resolved with use of a walker.
A standard walker may include wheels and glide-type brakes.
A wheeled walker is one with 2, 3, or 4 wheels. The wheels
may be fixed or swivel. It may be fixed height or adjustable
height. It may or may not include glide-type brakes (or
equivalent).
A glide-type brake consists of a spring mechanism (or
equivalent), which raises the leg post of the walker off the
ground when the member is not pushing down on the frame.
Pediatric Walkers and Crawlers
Aetna considers pediatric crawlers medically necessary DME
for disabled children.
The Mulholland Walkabout is a walker with 4 wheels and
attached back brace. Aetna considers the Mulholland
Walkabout medically necessary DME for children who have
impaired ambulation and who lack trunk stability and balance.
Note: Aetna does not cover standard strollers because they do
not meet Aetna's contractual definition of covered DME in that
they are not primarily medical in nature and they are normally
of use in the absence of illness or injury.
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Specially adapted strollers may be considered medically
necessary DME when they are used in place of a wheelchair
for children.
CPB 0271 - Wheelchairs and Power Operated Vehicles
See (Scooters) (../200_299/0271.html)
.
Prone, Supine and Upright Standers for Children with Special Needs
These floor/mobile standers for children (e.g., Rifton Supine,
Prone or Dynamic; Squiggles) are considered medically
necessary DME for children with cerebral palsy or other severe
neuromuscular conditions.
Heavy-Duty Walker
A heavy-duty walker is one that is labeled as capable of
supporting members who weigh more than 300 pounds. It
may be fixed height or adjustable height. It may be rigid or
folding. A heavy-duty walker is considered medically
necessary DME for members who meet medical necessity
criteria for a standard walker and who weigh more than 300
pounds.
A heavy-duty walker may include wheels and glide-type
brakes. A wheeled walker is one with 2, 3, or 4 wheels. The
wheels may be fixed or swivel. It may be fixed height or
adjustable height. It may or may not include glide-type brakes
(or equivalent). A glide-type brake consists of a spring
mechanism (or equivalent), which raises the leg post of the
walker off the ground when the member is not pushing down
on the frame.
Heavy-Duty, Multiple Braking System, Variable Wheel Resistance Walker
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A heavy-duty, multiple braking system, variable wheel
resistance walker is considered medically necessary DME for
members who meet medical necessity criteria for a standard
walker and who are unable to use a standard walker due to a
severe neurological disorder or other condition causing the
restricted use of one hand. Obesity, by itself, is not considered
a medically necessary indication for this walker.
Note: For purposes of this policy, a “heavy-duty, multiple
braking system, and variable wheel resistance walker” is a
4-wheeled, adjustable height, folding-walker that has all of the
following characteristics:
1. At least 2 wheels have brakes that can be independently
set through tension adjustability to give varying resistance,
and
2. Capable of supporting individuals who weigh greater than
350 pounds, and
3. Hand operated brakes that cause the wheels to lock when
the hand levers are released, and
4. The hand brakes can be set so that either or both can lock
the wheels, and
5. The pressure required to operate each hand brake is
individually adjustable, and
6. There is an additional braking mechanism on the front
crossbar
Walker with Enclosed Frame
Consistent with Medicare policy, Aetna does not cover walkers
with enclosed frames because their medical necessity
compared to a standard folding wheeled walker has not been
established. A walker with enclosed frame is a folding wheeled
walker that has a frame that completely surrounds the member
and an attached seat in the back.
Walker with Trunk Support
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A walker with trunk support is considered medically
necessary for members who meet medical necessity criteria
for a standard walker and who have documentation in the
medical record justifying the medical necessity for the special
features.
Kneeling Walker/Knee Walker/RollingKnee Walker/ Kneeling Crutch
Aetna considers a kneeling walker/knee walker/rolling knee
walker (e.g., Roll-A-Bout Walker, Rolleraid, Turning Leg
Caddy) or a kneeling crutch (e.g., iWALKFree]) medically
necessary DME for below-the-knee injuries/conditions if the
member meets criteria for a standard walker, crutch or cane,
but is unable to use one of those devices due to other
impairments (e.g., member only has one functional arm, etc.).
Enhancement Accessories
Aetna does not cover enhancement accessories of walkers,
canes and crutches as these are considered convenience
items. An enhancement accessory is one that does not
contribute significantly to the therapeutic function of the
walker, cane or crutch. It may include, but is not limited to
style, color, hand operated brakes (other than those described
in the section above on heavy duty, multiple braking system,
variable wheel resistance walker), seat attachments, tray
attachments, baskets or cup holders (or equivalent).
Leg Extensions
Leg extensions are considered medically necessary DME for
members 6 feet tall or more.
Arm Rests
Arm rest attachments are considered medically necessary
DME when the member's ability to grip is impaired.
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Walking Belts
Note: Aetna does not cover walking belts (belts used to
support and guide the member in walking) because they do
not meet Aetna's contractual definition of DME in that they are
not primarily medical in nature and they are normally of use to
persons who do not have a disease or injury.
Gait Trainers: The Rifton Gait Trainer/Pacer Gait Trainer, The KidWalk Gait Mobility System, and the Therapeutic Ambulatory Orthotic System (TAOS)
A gait trainer (or sometimes referred to as a rollator) is a term
used to describe certain devices that are used to support
a member during ambulation.
Aetna considers the Rifton Gait Trainer/Pacer Gait
Trainer medically necessary DME for children and adults with
cerebral palsy or other neuromuscular disorders who require
moderate to maximum support for walking and who are
capable of walking with this device.
The Rifton Gait Trainer is a type of walker, which provides
considerable postural support for the user. It comes in a range
of sizes that caters for tiny children through to adults. Each
size has a range of adjustable features that can be adjusted to
meet individual needs. This walker has been superseded by
the Pacer Gait Trainer, which is a redesign of the Rifton Gait
Trainer. It is suitable for children and adults who require
moderate to maximum support for walking. The frame is made
of aluminum. The large casters offer a range of functions --
gradual brake/drag, brake lock, swivel, swivel lock and 1-way
ratchet control. This gives a wide range of control in speed,
direction and maneuverability. Three sizes are available --
user elbow heights from 44.5 to 119.5 cm.
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Aetna considers the KidWalk Gait Mobility System and the
Therapeutic Ambulatory Orthotic System (TAOS) medically
necessary DME for children with cerebral palsy or other
neuromuscular disorders who require moderate to maximum
support for walking and are capable of walking with these
devices.
The TAOS is an orthotic and a walker base. According to the
manufacturer, these 2 components work together to provide a
child with cerebral palsy an upright hands-free environment.
The manufacturer states that the orthotic guides the child into
proper alignment so they can train the proper muscles. The
base holds the child in a standing position and provides
security for them to explore and improve.
Wearable Freezing of Gait Detection System
Aetna considers the use of a wearable freezing of gait
detection system for assisting walking of individuals with
Parkinson's disease experimental and investigational because
of insufficient evidence in the peer-reviewed literature.
Autoambulators
Aetna considers the Autoambulator experimental and
investigational because the clinical evidence is not sufficient to
permit conclusions on the health outcome effects of the
Autoambulator.
Background
This policy is based, in part, upon Medicare DME MAC Local
Medical Policy.
Approximately 50 % of the patients with advanced Parkinson's
disease (PD) suffer from freezing of gait (FOG), which is a
sudden and transient inability to walk. It often causes falls,
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interferes with daily activities and significantly impairs quality of
life. Because gait deficits in PD patients are often resistant to
pharmacotherapies, effective non-pharmacotherapiess are of
special interest. Bachlin and colleagues (2010) evaluated the
concept of a wearable device that can obtain real-time gait
data, processes them and provides assistance based on pre-
determined specifications. This wearable system uses on-
body acceleration sensors to measure the patients'
movements. It automatically detects FOG by analyzing
frequency components inherent in these movements. When
FOG is detected, the assistant provides a rhythmic auditory
signal that stimulates the patient to resume walking. These
investigators evaluated their wearable assistive technology in a
study with 10 PD patients. Over 8 hours of data were recorded,
and a questionnaire was filled out by each patient. A total of
237 FOG events have been identified by professional
physiotherapists in a post-hoc video analysis. The device
detected the FOG events online with a sensitivity of 73.1 % and
a specificity of 81.6 % on a 0.5-sec frame-based evaluation.
The authors concluded that these findings showed that online
assistive feedback for PD patients is possible.
They stated that their results demonstrated the benefit of such
a context-aware system and motivated further studies.
The Autoambulator
The Autoambulator is a therapeutic robotic machine developed
to rehabilitate individuals recovering from conditions affecting
walking such as stroke, spinal cord injury, and hip or knee
replacement surgery. The AutoAmbulator features an overhead
harness system to fully support the patient, mechanically
powered braces to move the patient's legs, and numerous
computerized sensors to track vital signs, movement, and
contact speed, adjusting speed accordingly.
Researchers are evaluating the AutoAmbulator's ability to
increase blood flow in patients' legs, decrease muscle spasms,
and improve respiration and circulatory function.
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Schmidt et al (2007) stated that gait restoration is an integral
part of rehabilitation of brain lesioned patients. Modern concepts
favor a task-specific repetitive approach, i.e., who wants to
regain walking has to walk, while tone-inhibiting and gait
preparatory maneuvers had dominated therapy before.
Following the first mobilization out of the bed, the wheelchair-
bound patient should have the possibility to practice complex
gait cycles as soon as possible. Steps in this direction were
treadmill training with partial body weight support and most
recently gait machines enabling the repetitive training of even
surface gait and even of stair climbing. With treadmill training
harness-secured and partially relieved wheelchair-mobilized
patients could practice up to 1,000 steps per session for the
first time. Controlled trials in stroke and spinal cord injured (SCI)
patients, however, failed to show a superior result when
compared to walking exercise on the floor. Most likely
explanation was the effort for the therapists, e.g., manually
setting the paretic limbs during the swing phase resulting in a
too little gait intensity. The next steps were gait machines,
either consisting of a powered exoskeleton and a treadmill
(Lokomat, AutoAmbulator) or an electro-mechanical solution
with the harness secured patient placed on movable foot
plates (Gait Trainer GT I). For the latter, a large multi-center trial
with 155 non-ambulatory stroke patients (DEGAS) revealed a
superior gait ability and competence in basic activities of living in
the experimental group. The HapticWalker continued the end
effector concept of movable foot plates, now fully programmable
and equipped with 6 degree of freedom (DOF) force sensors.
This device for the first-time enabled training of arbitrary walking
situations, hence not only the simulation of floor walking but also
for example of stair climbing and perturbations. The authors
concluded that locomotor therapy is a fascinating new tool in
rehabilitation, which is in line with modern principles of motor
relearning promoting a task-specific repetitive approach.
Moreover, they stated that sophisticated technical developments
and positive
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randomized controlled trials (RCTs) form the basis of a
growing acceptance worldwide to the benefits of stroke and
SCI patients.
In a systematic review, Swinnen and colleagues (2014)
summarized the improvements in balance after robot-assisted
gait training (RAGT) in stroke patients; PubMed and Web of
Knowledge were searched. The most important words were
"stroke", "RAGT", "balance", "Lokomat" and "gait trainer".
Studies were included if stroke patients were involved in
RAGT protocols, and balance was determined as an outcome
measurement. The articles were checked for methodological
quality by 2 reviewers (Cohen's κ = 0.72). A total of 9 studies
were included (7 true experimental and 2 pre-experimental
studies; methodological quality score, 56 % to 81 %). In total,
229 sub-acute or chronic stroke patients (70.5 % male) were
involved in RAGT (3 to 5 times per week, 3 to 10 weeks, 12 to
25 sessions). In 5 studies, the gait trainer was used; in 2, the
Lokomat was used; in 1 study, a single-joint wearable knee
orthosis was used; and in 1 study, the AutoAmbulator was
used. A total of 8 studies compared RAGT with other gait
rehabilitation methods. Significant improvements (no to large
effect sizes, Cohen's d = 0.01 to 3.01) in balance scores
measured with the Berg Balance Scale, the Tinetti test,
postural sway tests, and the Timed Up and Go test were found
after RAGT. No significant differences in balance between the
intervention and control groups were reported. Robot-assisted
gait training can lead to improvements in balance in stroke
patients; however, it is not clear whether the improvements are
greater compared with those associated with other gait
rehabilitation methods. The authors concluded that because a
limited number of studies are available, more specific research
(e.g., RCTs with larger, specific populations) is needed to draw
stronger conclusions.
According to Winchester and Querry (2006), robotic orthoses
for body weight-supported treadmill training (BWSTT) has
become an accepted standard of care in gait rehabilitation
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methods. This type of locomotor training has many functional
benefits, but the physical labor costs are considerable. To
reduce therapist effort and improve the repeatability of
locomotor training, 3 groups have developed commercially
available robotic devices for assisted stepping. The purpose
of these robotic devices is to augment locomotor rehabilitation
by decreasing therapist manual assistance, increasing the
amount of stepping practice, while decreasing therapist effort.
Current clinical studies have yielded positive and promising
results in locomotor rehabilitation inpatients with neurologic
impairments of stroke or spinal cord injury. The potential
benefits from robotic technology are significant for clinical use
and research. As further research is conducted, rehabilitation
therapists and patient outcomes will be able to contribute to
the development of current and future technologies.
Wearable Freezing of Gait Detection System
Jovanov et al (2009) stated that freezing of gait (FOG) is a
common complication in movement disorders, typically
associated with the advanced stages of Parkinson's disease
(PD). Auditory cues might be used to facilitate unfreezing of
gait and prevent fall related injuries. These investigators
presented a wearable, unobtrusive system for real-time gait
monitoring, which consists of an inertial wearable sensor and
wireless headset for the delivery of acoustic cues. The system
recognizes FOG episodes with minimum latency and delivers
acoustic cues to unfreeze the gait. They presented design of
a system for the detection and unfreezing of gait (deFOG), and
preliminary results of the feasibility study. In a limited test run
of 4 test cases, the system was able to detect FOG with
average latency of 332 ms, and maximum latency of 580 ms.
Coste et al (2014) noted that FOG is a common symptom in
patients with PD, which affects the gait pattern and is
associated to a fall risk. Automatized FOG episode detection
would allow systematic assessment of patient state and
objective evaluation of the clinical effects of treatments.
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Techniques have been proposed in the literature to identify
FOG episodes based on the frequency properties of inertial
sensor signals. These researchers adapted and extended
these FOG detectors in order to include other associated gait
pattern changes, like festination. The proposed approach was
based on a single wireless inertial sensor placed on the
patient's lower limbs. The preliminary experimental results
showed that existing frequency-based freezing detectors are
not sufficient to detect all FOG and festination episodes and
that the observation of some gait parameters such as stride
length and cadence are valuable inputs to anticipate the
occurrence of upcoming FOG events.
Appendix
The item in Column II is included in the allowance for the
corresponding item in Column I when provided at the same
time and must not be billed separately at the time of billing the
item in Column.
Column I Column II
WALKER, RIGID (PICKUP),
ADJUSTABLE OR FIXED
HEIGHT
REPLACEMENT,
HANDGRIP, CANE,
CRUTCH, OR WALKER,
EACH
REPLACEMENT, TIP,
CANE, CRUTCH, WALKER,
EACH.
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WALKER, FOLDING (PICKUP), REPLACEMENT,
ADJUSTABLE OR FIXED HANDGRIP, CANE,
HEIGHT CRUTCH, OR WALKER,
EACH
REPLACEMENT, TIP,
CANE, CRUTCH, WALKER,
EACH.
WALKER, WITH TRUNK
SUPPORT, ADJUSTABLE OR
FIXED HEIGHT, ANY TYPE
REPLACEMENT,
HANDGRIP, CANE,
CRUTCH, OR WALKER,
EACH
REPLACEMENT, TIP,
CANE, CRUTCH, WALKER,
EACH.
WHEEL ATTACHMENT,
RIGID PICK-UP WALKER,
PER PAIR
BRAKE ATTACHMENT FOR
WHEELED WALKER,
REPLACEMENT, EACH
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WALKER, RIGID, WHEELED,
ADJUSTABLE OR FIXED
HEIGHT
REPLACEMENT,
HANDGRIP, CANE,
CRUTCH, OR WALKER,
EACH
REPLACEMENT, TIP,
CANE, CRUTCH, WALKER,
EACH.
WHEEL ATTACHMENT,
RIGID PICK-UP WALKER,
PER PAIR
BRAKE ATTACHMENT FOR
WHEELED WALKER,
REPLACEMENT, EACH
WALKER, FOLDING,
WHEELED, ADJUSTABLE OR
FIXED HEIGHT
REPLACEMENT,
HANDGRIP, CANE,
CRUTCH, OR WALKER,
EACH
REPLACEMENT, TIP,
CANE, CRUTCH, WALKER,
EACH.
WHEEL ATTACHMENT,
RIGID PICK-UP WALKER,
PER PAIR
BRAKE ATTACHMENT FOR
WHEELED WALKER,
REPLACEMENT, EACH
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WALKER, ENCLOSED, FOUR
SIDED FRAMED, RIGID OR
FOLDING, WHEELED WITH
POSTERIOR SEAT
REPLACEMENT,
HANDGRIP, CANE,
CRUTCH, OR WALKER,
EACH
REPLACEMENT, TIP,
CANE, CRUTCH, WALKER,
EACH.
WHEEL ATTACHMENT,
RIGID PICK-UP WALKER,
PER PAIR
BRAKE ATTACHMENT FOR
WHEELED WALKER,
REPLACEMENT, EACH
SEAT ATTACHMENT,
WALKER
WALKER, HEAVY DUTY,
MULTIPLE BRAKING SYSTEM,
VARIABLE WHEEL
RESISTANCE
REPLACEMENT,
HANDGRIP, CANE,
CRUTCH, OR WALKER,
EACH
WHEEL ATTACHMENT,
RIGID PICK-UP WALKER,
PER PAIR
BRAKE ATTACHMENT FOR
WHEELED WALKER,
REPLACEMENT, EACH
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WALKER, HEAVY DUTY,
WITHOUT WHEELS, RIGID OR
FOLDING, ANY TYPE, EACH
REPLACEMENT,
HANDGRIP, CANE,
CRUTCH, OR WALKER,
EACH
REPLACEMENT, TIP,
CANE, CRUTCH, WALKER,
EACH.
WALKER, HEAVY DUTY,
WHEELED, RIGID OR
FOLDING, ANY TYPE
REPLACEMENT,
HANDGRIP, CANE,
CRUTCH, OR WALKER,
EACH
REPLACEMENT, TIP,
CANE, CRUTCH, WALKER,
EACH.
WHEEL ATTACHMENT,
RIGID PICK-UP WALKER,
PER PAIR
BRAKE ATTACHMENT FOR
WHEELED WALKER,
REPLACEMENT, EACH
CPT Codes / HCPCS Codes / ICD-10 Codes
Information in the [brackets] below has been added for clarification purposes. Codes requiring a 7th character are represented by "+":
Code Code Description
HCPCS codes covered if selection criteria are met:
A4635 Underarm pad, crutch, replacement, each
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Code Code Description
A4636 Replacement, handgrip, cane, crutch, or walker,
each
A4637 Replacement, tip, cane, crutch, or walker, each
E0100 Cane, includes canes of all materials,
adjustable or fixed, with tip
E0105 Cane, quad or three-prong, includes canes of
all materials, adjustable or fixed, with tips
E0110 Crutches, forearm, includes crutches of various
materials, adjustable of fixed, pair, complete
with tips and handgrips
E0111 Crutch, forearm, includes crutches of various
materials, adjustable or fixed, each, with tip and
handgrip
E0112 Crutches, underarm, wood, adjustable or fixed,
pair, with pads, tips and handgrips
E0113 Crutch, underarm, wood, adjustable or fixed,
each, with pad, tip and handgrip
E0114 Crutches, underarm, other than wood,
adjustable or fixed, pair, with pads, tips and
handgrips
E0116 Crutch, underarm, other than wood, adjustable
or fixed, with PAD, tip, handgrip, with or without
shock absorber, each
E0118 Crutch substitute, lower leg platform, with or
without wheels, each [iWalkFree]
E0130 Walker, rigid (pick-up), adjustable or fixed
height
E0135 Walker, folding (pickup), adjustable or fixed
height
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Code Code Description
E0140 Walker, with trunk support, adjustable or fixed
height, any type
E0141 Walker, rigid, wheeled, adjustable or fixed
height
E0143 Walker, folding, wheeled, adjustable or fixed
height
E0147 Walker, heavy duty, multiple braking system,
variable wheel resistance
E0148 Walker, heavy duty, without wheels, rigid or
folding, any type, each
E0149 Walker, heavy duty, wheeled, rigid or folding,
any type
E0153 Platform attachment, forearm crutch, each
E0154 Platform attachment, walker, each
E0155 Wheel attachment, rigid pick-up walker, per pair
seat attachment, walker
E0157 Crutch attachment, walker, each
E0158 Leg extensions for walker, per set of four (4)
E0159 Brake attachment for wheeled walker,
replacement, each
E0638 Standing frame system, one position (e.g.,
upright, supine or prone stander), any size
including pediatric, with or without wheels
E0641 Standing frame system, multi-position (e.g.,
three way stander), any size including pediatric,
with or without wheels
E0642 Standing frame system, mobile (dynamic
stander), any size including pediatric
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The above policy is based on the following references:
1. U.S. Department of Health and Human Services, Health
Care Financing Administration (HCFA). Medicare
Coverage Issues Manual §§60-3, 60-9, 60-15. Baltimore,
MD; HCFA; 1999.
2. Lehman JF, Lateur BJ. Gait analysis. Diagnosis and
management. In: Krusen's Handbook of Physical
Medicine and Rehabilitation. 4tth ed. FJ Kottke, JF
Code Code Description
E1031 Rollabout chair, any and all types with castors
5” or greater [Rolleraid]
E8000 Gait trainer, pediatric size, posterior support,
includes all accessories and components
E8001 Gait trainer, pediatric size, upright support,
includes all accessories and components
E8002 Gait trainer, pediatric size, anterior support,
includes all accessories and components
HCPCS codes not covered for indications listed in the CPB:
Sit-and-stand walking assistant crutch - no specific code:
E0117 Crutch, underarm, articulating, spring assisted,
each
E0144 Walker, enclosed, four sided framed, rigid or
folding, wheeled with posterior seat
E0156 Seat attachment, walker
ICD-10 codes:
Too many to list.
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Copyright Aetna Inc. All rights reserved. Clinical Policy Bulletins are developed by Aetna to assist in administering plan
benefits and constitute neither offers of coverage nor medical advice. This Clinical Policy Bulletin contains only a partial,
general description of plan or program benefits and does not constitute a contract. Aetna does not provide health care
services and, therefore, cannot guarantee any results or outcomes. Participating providers are independent contractors
in private practice and are neither employees nor agents of Aetna or its affiliates. Treating providers are solely
responsible for medical advice and treatment of members. This Clinical Policy Bulletin may be updated and therefore is
subject to change.
Copyright © 2001-2019 Aetna Inc.
AETNA BETTER HEALTH® OF PENNSYLVANIA
Amendment to Aetna Clinical Policy Bulletin Number: 0505 Ambulatory
Assist Devices Walkers, Canes, and Crutches.
There are no amendments for Medicaid.
www.aetnabetterhealth.com/pennsylvania annual 02/01/2019