Canes and Crutches

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Physician Documentation Requirements

Canes and Crutches

  • Detailed Written Order That Contains:
    • Patient's Name
    • Detailed Description of the Item(s) to Be Ordered
    • Length of Need the Patient Will Require the Item(s)
    • Physician's Printed Name
    • Physician's NPI
    • Physician's Signature
    • Physician's Date of Signature
  • Face-to-face evaluation dated within 6 months of the detailed written order documenting:
    • Patient's diagnoses or conditions that warrant the medical necessity of the item
  • And all of the following criteria are met:
    • The patient has a mobility limitation that significantly impairs his/her ability to participate in one or more MRADLs within the home; AND
    • The patient is able to safely use the cane or crutch; AND
    • The functional mobility deficit can be sufficiently resolved by the cane or crutch

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