Dynamic Joint Extension and Flexion Orthoses - DME.MU.202.A

Covers dynamic upper and lower extremity orthoses (shoulder/elbow/wrist/hand/finger and lower‑extremity designs) for limited joint ROM or stiffness from injury/surgery, nerve compression, arthritis, tendon inflammation, muscle weakness, contracture, or spasticity; duplication of same/similar orthoses is not medically necessary. Requires documentation that the brace will be used with exercise and adjusted as ROM changes, a recent provider visit with a documented care plan and qualifying diagnosis, and for replacements clinical evidence of growth/change, loss/theft, or irreparable damage not under warranty.

"Dynamic upper or lower extremity orthosis is indicated for both of the following:"

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