LCD for Cervical Traction Devices (L15844)

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Contractor Information

Contractor Name 

NHIC 

Contractor Number 

16003 

Contractor Type 

DME MAC 

 

LCD Information

LCD ID Number 

L15844 

 

LCD Title 

Cervical Traction Devices 

 

Contractor's Determination Number 

CTD20080101 

 

AMA CPT / ADA CDT Copyright Statement 

CPT codes, descriptions and other data only are copyright 2007 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Clauses Apply. Current Dental Terminology, (CDT) (including procedure codes, nomenclature, descriptors and other data contained therein) is copyright by the American Dental Association. © 2002, 2004 American Dental Association. All rights reserved. Applicable FARS/DFARS apply.  

 

CMS National Coverage Policy 

CMS Pub. 100-3, Medicare National Coverage Determinations Manual, Chapter 1, Section 280.1 

 

Primary Geographic Jurisdiction 

Connecticut
District of Columbia
Delaware
Massachusetts
Maryland
Maine
New Hampshire
New Jersey
New York - Entire State
Pennsylvania
Rhode Island
Vermont
 

 

Oversight Region 

Region III
 

Original Determination Effective Date 

For services performed on or after 07/01/2004  

 

Original Determination Ending Date 

 

 

Revision Effective Date 

For services performed on or after 01/01/2008  

 

Revision Ending Date 

 

 

Indications and Limitations of Coverage and/or Medical Necessity 

For any item to be covered by Medicare, it must 1) be eligible for a defined Medicare benefit category, 2) be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member, and 3) meet all other applicable Medicare statutory and regulatory requirements. For the items addressed in this medical policy, the criteria for "reasonable and necessary" are defined by the following indications and limitations of coverage and/or medical necessity.

For an item to be covered by Medicare, a written signed and dated order must be received by the supplier before a claim is submitted. If the supplier bills for an item addressed in this policy without first receiving the completed order, the item will be denied as not medically necessary.

Cervical traction devices (E0840-E0860) are covered only if both of the following criteria are met:

1. The patient has a musculoskeletal or neurologic impairment requiring traction equipment; and,

2. The appropriate use of a home cervical traction device has been demonstrated to the patient and the patient tolerated the selected device.

If criteria 1 and 2 are not met, cervical traction will be denied as not medically necessary.

Cervical traction applied via attachment to a headboard (E0840) or a free-standing frame (E0850) has no proven clinical advantage compared to cervical traction applied via an over-the-door mechanism (E0860). If an E0840 or E0850 is ordered and the medical necessity criteria for cervical traction devices are met, reimbursement will be based on the allowance for the least costly medically appropriate alternative (E0860).

Cervical traction devices described by code E0849 or E0855 are covered only when criteria 1 and 2 above and either criteria A, B or C below have been met:

A. The patient has a diagnosis of temporomandibular joint (TMJ) dysfunction; and has received treatment for the TMJ condition; or,

B. The patient has distortion of the lower jaw or neck anatomy (e.g., radical neck dissection) such that a chin halter is unable to be utilized; or,

C. The treating physician orders and/or documents the medical necessity for greater than 20 pounds of cervical traction in the home setting.

If the criteria for cervical traction are met but the additional criteria for E0849 or E0855 are not met, reimbursement will be based on the allowance for the least costly medically appropriate alternative (E0860).

E0856 describes a cervical traction device that can be used with ambulation. Therefore, it will be denied as not medically necessary. 

 

Coverage Topic 

Durable Medical Equipment
 

 

Coding Information

 

CPT/HCPCS Codes 

The appearance of a code in this section does not necessarily indicate coverage.

HCPCS MODIFIERS:

EY - No physician or other licensed health care provider order for this item or service.

KX - Specific required documentation on file.

HCPCS CODES:

E0840

TRACTION FRAME, ATTACHED TO HEADBOARD, CERVICAL TRACTION

E0849

TRACTION EQUIPMENT, CERVICAL, FREE-STANDING STAND/FRAME, PNEUMATIC, APPLYING TRACTION FORCE TO OTHER THAN MANDIBLE

E0850

TRACTION STAND, FREE STANDING, CERVICAL TRACTION

E0855

CERVICAL TRACTION EQUIPMENT NOT REQUIRING ADDITIONAL STAND OR FRAME

E0856

CERVICAL TRACTION DEVICE, CERVICAL COLLAR WITH INFLATABLE AIR BLADDER

E0860

TRACTION EQUIPMENT, OVERDOOR, CERVICAL

 

 

ICD-9 Codes that Support Medical Necessity 

Not specified

 

 

 

Diagnoses that Support Medical Necessity 

Not specified 

 

ICD-9 Codes that DO NOT Support Medical Necessity 

Not specified

 

 

 

ICD-9 Codes that DO NOT Support Medical Necessity Asterisk Explanation 

 

 

Diagnoses that DO NOT Support Medical Necessity 

Not specified 

 

General Information

Documentation Requirements 

Section 1833(e) of the Social Security Act precludes payment to any provider of services unless "there has been furnished such information as may be necessary in order to determine the amounts due such provider." It is expected that the patient’s medical records will reflect the need for the care provided. The patient’s medical records include the physician’s office records, hospital records, nursing home records, home health agency records, records from other healthcare professionals and test reports. This documentation must be available upon request.

An order for the cervical traction device must be signed and dated by the treating physician, kept on file by the supplier, and be available upon request. Items billed before a signed and dated order has been received by the supplier must be submitted with an EY modifier added to each affected HCPCS code.

Suppliers must add a KX modifier to code E0849 or E0855 only if all of the criteria in the "Indications and Limitations of Coverage and/or Medical Necessity" section of this policy have been met and evidence of such is maintained in the supplier's files. This information must be available upon request.

Refer to the Supplier Manual for more information on documentation requirements.
 

 

Appendices 

 

 

Utilization Guidelines 

Refer to Indications and Limitations of Coverage and/or Medical Necessity. 

 

Sources of Information and Basis for Decision 

 

 

Advisory Committee Meeting Notes 

 

 

Start Date of Comment Period 

11/03/2003 

 

End Date of Comment Period 

12/19/2003 

 

Start Date of Notice Period 

03/01/2004 

 

Revision History Number 

CTD004 

 

Revision History Explanation 

3/1/2008- In accordance with Section 911 of the Medicare Modernization Act, this policy was transitioned to DME MAC NHIC (16003) LCD L15844 from DME PSC TriCenturion (77011) LCD L15844.

Revision Effective Date: 01/01/2008
INDICATIONS AND LIMITATIONS OF COVERAGE
Added: Coverage statement regarding E0856.
HCPCS CODES AND MODIFIERS:
Added: E0856

Revision Effective Date: 01/01/2007
INDICATIONS AND LIMITATIONS OF COVERAGE:
Removed references to the DMERC.
Expanded allowance for coverage of E0855.
DOCUMENTATION REQUIREMENTS:
Removed references to the DMERC.
Removal of the “SOURCES OF INFORMATION”.


Revision effective date: 07/01/2006
INDICATIONS AND LIMITATIONS OF COVERAGE:
Separate allowance of coverage of E0855 if both Cervical Traction criteria and the noted additional criteria A and B are met.
DOCUMENTATION REQUIREMENTS:
Added requirements for use of KX with E0855.
REVISED SOURCES OF INFORMATION AND BASIS FOR DECISION:
Revised

03/01/2006 - In accordance with Section 911 of the Medicare Modernization Act of 2003, this policy was transitioned to DME PSC TriCenturion (77011) from DMERC Tricenturion (77011).

Revision effective date: 04/01/2005
HCPCS CODES AND MODIFIERS:
K0627 crosswalked to E0849



06/01/2007 - In accordance with Section 911 of the Medicare Modernization Act of 2003, Virginia and West Virginia were transitioned from DME PSC TriCenturion (77011) to DME PSC TrustSolutions (77012).

 

Last Reviewed On Date 

 

 

Related Documents 

Article(s)
A17919 - Cervical Traction Devices – Policy Article – Effective April 2005 - Revised

 

LCD Attachments 

There are no attachments for this LCD

 

 

Article for Cervical Traction Devices – Policy Article – Effective April 2005 - Revised (A17919)

Top of Form

Bottom of Form

 

Contractor Information

Contractor Name 

NHIC 

Contractor Number 

16003 

Contractor Type 

DME MAC 

 

Article Information

Article ID Number 

A17919 

Article Type 

Article

Key Article 

Yes

Article Title 

Cervical Traction Devices – Policy Article – Effective April 2005 - Revised 

AMA CPT / ADA CDT Copyright Statement 

CPT codes, descriptions and other data only are copyright 2007 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Clauses Apply. Current Dental Terminology, (CDT) (including procedure codes, nomenclature, descriptors and other data contained therein) is copyright by the American Dental Association.© 2002, 2004 American Dental Association. All rights reserved. Applicable FARS/DFARS apply.

 

Primary Geographic Jurisdiction 

Connecticut
District of Columbia
Delaware
Illinois
Indiana
Kentucky
Massachusetts
Maryland
Maine
Michigan
Minnesota
New Hampshire
New Jersey
New York - Entire State
Ohio
Pennsylvania
Rhode Island
Virginia
Vermont
Wisconsin
West Virginia
 

Original Article Effective Date 

07/01/2004

Article Revision Effective Date 

06/01/07

Article Text 

NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES

Cervical traction devices are covered under the durable medical equipment (DME) benefit. Cervical orthoses, such as soft or rigid cervical collars, are not considered DME; however, they are eligible for Medicare coverage under the Brace benefit.


CODING GUIDELINES

Code E0855 describes cervical traction devices that provide traction on the cervical anatomy without the use of a door or external frame or stand. Traction may be applied by means of mandibular or occipital pressure.

Code E0860 describes cervical traction devices that provide traction on the cervical anatomy through a system of pulleys and rope and are attached to a door. Traction may be applied in either the upright or supine position.

Code E0849 describes cervical traction devices that provide traction on the cervical anatomy through the use of a free-standing frame. Traction force is applied by means of pneumatic displacement to anatomical areas other than the mandible (e.g., the occipital region of the skull). Devices described by code E0849 must be capable of generating traction forces greater than 20 pounds. In addition, code E0849 devices allow traction to be applied with alternative vectors of force (e.g., 15 degrees of lateral neck flexion).

Suppliers should contact the Statistical Analysis Durable Medical Equipment Regional Carrier (SADMERC) for guidance on the correct coding of these items.

Coverage Topic 

Durable Medical Equipment
 

 

Coding Information

No Coding Information has been entered in this section of the article.

 

Other Information

Revision History Explanation 

3/01/2008- In accordance with Section 911 of the Medicare Modernization Act, this policy was transitioned to DME MAC NHIC (16003) Article A17919 from DME PSC TriCenturion (77011) Article A17919.

 

06/01/2007 - In accordance with Section 911 of the Medicare Modernization Act of 2003, Virginia and West Virginia were transitioned from DME PSC TriCenturion (77011) to DME PSC TrustSolutions (77012).

 

03/01/2006 - In accordance with Section 911 of the Medicare Modernization Act of 2003, this article was transitioned to DME PSC TriCenturion (77011) from DMERC Tricenturion (77011).

Revision effective date: 04/01/2005
CODING GUIDELINES:
K0627 crosswalked to E0849


 

Related Documents 

 

LCD(s)
L15844 - Cervical Traction Devices