February 28, 2013 - Republished: 12.14.21
Continuous Passive Motion (CPM) Devices – Coverage Reminder
Use of continuous passive range of motion devices (CPM) is covered by Medicare only after a total knee replacement or a revision of a major component of a previously performed total knee replacement. CPMs are not covered 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. The DME MAC should be billed only for those days of CPM treatment after discharge from the hospital.
When billing for a CPM (HCPCS code E0935), all of the following documentation must be included with the claim:
- 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 facts are not documented, the claim will be denied for lack of medical necessity.