Yes, focus on the Medicare requirements. Hit me up for any additional information and good blessings to you
The Continuous Passive Motion (CPM) device (E0935) used for the knee due to total knee replacement is eligible for coverage and reimbursement through the DME MAC. All of the following criteria must be met for coverage:
1. The device must be prescribed by a physician.
2. The patient must have undergone a total knee replacement (TKR).
3. The use of the device must commence within two days of the date of surgery.
Coverage is limited to that part of a 21-day period, beginning with the date of surgery, during which the device is used in the patient's home.
Documentation of the following dates must accompany the claim:
1. Date of surgery
2. Date CPM therapy began
3. Date of discharge from the hospital
The dates listed above should be included in Item 19 for paper claims or submitted on an attachment. An electronic claim should include these details in the NTE 2400 (claim line) or 2300 (claim header) loop. Documentation of a valid diagnosis or narrative of a total knee replacement (TKR) is also required.
Claims submitted without the above information will be denied.
