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Indications for Medical Necessity

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Elbow Brace Indications for Prescribed PT:

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Pt requires brace:

⃝     To provide stabilization to weak or injured elbow/forearm
⃝     To prevent elbow/forearm flexion, extension, rotation, and deviation
⃝     To provide treatment of carpal tunnel syndrome, tendinitis or Rheumatoid arthritis
⃝     Post-surgical treatment of elbow/forearm
⃝     Post cast healing or soft tissue injury

 

 

Clinical Note Requirements: Dictation must be exactly as shown above for the indication chosen.

RX/DWO

Elbow

L3762

Most common ICD-10 codes:

G56.00 - Carpal tunnel syndrome, upper limb

M05.62X - Rheumatoid arthritis of elbow
S50.X - Superficial injury of elbow/forearm
S51.X  - Open wound of elbow and forearm
S52.X - Fracture of forearm
S52.001A - Unspecified fracture of ulna
S52.011A  - Torus fracture of upper of ulna
S52.021A - Fracture of olecranon process without intraarticular extension of ulna
S52.031A  ‑  Fracture of olecranon process with intraarticular extension of ulna

S53.X - Dislocation and sprain of joints and ligaments of elbow

Elbow Document Requirements: Signed/Dated RX, Clinicals with Indications. Up to date patient demographics with insurance information.

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