Orthotics - MEDICAID - KENTUCKY

This Humana Medicaid medical coverage policy (Orthotics) lists orthotic devices and specific clinical indications where coverage may be considered medically necessary (e.g., AFOs for tibial fractures and Charcot neuroarthropathy, hip orthoses for abduction control and postoperative uses, spinal orthoses for specified fractures or deformities, foot/upper-extremity orthoses for immobilization/support, and repair/replacement rules). Coverage is conditional and requires physician prescription and clinical documentation of detailed description and medical necessity for many custom or unspecified items; wearable robotic exoskeletons (K1007) are explicitly not covered. Repair/replacement is allowed for anatomical change or reasonable wear and tear (with replacement typically every 1-3 years); abuse/misuse/neglect are excluded.

"L1680 - May be considered medically necessary to control hip abduction."