Canes

 
Note:  The following coverage criteria is for Medicare, other insurances may have different criteria and may be less stringent.  In most cases, meeting Medicare criteria will meet all other criteria’s.

• A written signed and dated prescription prior to dispensing is required before a cane is covered by Medicare.
• The face to face notes must include the conditions for coverage  as described below (these must be completed and signed prior to dispensing the item):

CRITERIA FOR A CANE
 
A cane is covered if all the following Criteria are met:

1. The patient has a mobility limitation that significantly impairs his/her ability to participate in one or more mobility-related activities of daily living (MRADL) in the home.
2. A mobility limitation is one that:
   • Prevents the patient from accomplishing the MRADL entirely, or
   • Places the patient at reasonably determined heightened risk of morbidity or mortality secondary to the attempts to perform the MRADL, or
   • Prevents the patient from completing the MRADL within a reasonable time frame; and
   • The patient is able to safely use the cane; and
   • The functional mobility deficit can be sufficiently resolved with the use of a cane

If all of the Criteria are not met, the cane will be denied as not medically necessary.
A heavy duty cane is covered for patients who meet coverage criteria for a cane and who weighs more than 300 pounds.