Skip to Main Content

Print | Bookmark | Email | Font Size: + |

Continuous Passive Motion (CPM) Devices – Coverage Reminder

Medicare covers the use of continuous passive range of motion devices (CPM) only after a total knee replacement or a revision of a major component of a previously performed total knee replacement. Medicare does not cover CPMs after any other type of knee or joint surgery. Coverage is limited to 21 days from the date of surgery, and the CPM must be applied within 48 hours of surgery to be eligible for Medicare coverage. You should only bill the the DME MAC for those days of CPM treatment after discharge from the hospital.

When billing for a CPM (HCPCS code E0935), add the following information in the claim narrative:

  • Type of knee surgery performed;
  • Date of surgery;
  • Date of application of CPM; and,
  • Date of discharge from the hospital.

If any of these four items are not documented, the claim will be denied for lack of medical necessity.

The narrative should be entered into the NTE 2400 (line note) or NTE 2300 (claim note) segments of the American National Standard Institute (ANSI X12) format, field 390-BM of the National Council for Prescription Drug Program (NCPDP) format, or Item 19 of paper claims.

Additional Resources:

Date: February 14, 2024

spacer

26 Century Blvd Ste ST610, Nashville, TN 37214-3685 © CGS Administrators, LLC. All Rights Reserved