CG-DME-52 Continuous Passive Motion Devices in the Home Setting

This policy addresses continuous passive motion (CPM) devices for home use after joint procedures (e.g., knee, hip, shoulder, elbow, wrist, ankle; HCPCS E0935, E0936). Anthem considers home use of CPM devices not medically necessary for all indications and therefore not covered. There are no covered exceptions under this policy; the noncoverage applies regardless of surgery type or diagnosis.

"Use of a continuous passive motion (CPM) device in the home setting is considerednot medically necessaryfor all indications."

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