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Indications for Medical Necessity

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⃝     Weakness of the knee and requires stabilization
⃝     Deformity of the knee that requires stabilization
⃝     A knee orthosis with condylar pads with OR without patellar control (circle one)
⃝     Has had a recent knee injury to the knee or a surgical procedure on the knee(s)

 

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

Patella Indications for Prescribed PT:

(Must select one of the following):

Patella Brace

L1820/L1833

Most common ICD-10 codes:

M22.2X1 - Patellofemoral disorders, right knee

M22.2X2 - Patellofemoral disorders, left knee

M22.8XX - Other disorders of patella

M23.51 - Chronic instability of knee, right knee
M23.52 - Chronic instability of knee, left knee

M25.56X - Pain in knee

M76.5X - Patellar tendinitis

S82.XX - Fracture of Patella

S83.004X - Unspecified dislocation of  patella, initial encounter

S83.30XA - Tear of articular cartilage of unspecified knee, current, initial encounter

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RX/DWO

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

Hinged Knee Indications for Prescribed PT:

(Must select one of the following):

⃝     Weakness of the knee and requires stabilization
⃝     Deformity of the knee that requires stabilization
⃝     A knee orthosis with condylar pads with OR without patellar control (circle one)
⃝     Has had a recent knee injury to the knee or a surgical procedure on the knee(s)

 

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

Hinged Knee Brace

L1833

Most common ICD-10 codes:

M22.2X - Patellofemoral disorders

M23.00X - Cystic meniscus,  lateral 
M23.003 - Cystic meniscus, medial 
M23.51- Chronic instability of knee, right knee
M23.52 - Chronic instability of knee, left knee

M94.261 - Chondromalacia, right knee

M94.262 - Chondromalacia, left knee

S83.32X - Tear of articular cartilage of knee

S83.4 - Sprain of collateral ligament of knee

S83.5 - Sprain of cruciate ligament of knee

Q68.2 - Congenital deformity of knee
Q68.6 - Discoid meniscus
Q74.1 - Congenital malformation of knee
 

Additional DX Codes

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

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