Cervical traction documentation needs
The following qualification criteria need to be documented in the patients’ medical record notes to qualify for the prescribed equipment. Note: Justification notes are valid for six months.
Over door cervical traction devices: 1 and 2 need to be sufficiently documented to support the need for the prescribed equipment
- Document the patients musculoskeletal or neurologic impairment requiring traction equipment; and
- Document the appropriate use of a home cervical traction device has been demonstrated to the patient and the beneficiary tolerated the traction device.
Freestanding Cervical traction devices: 1 and 2 above and either criteria A, B or C need to be sufficiently documented to support the need for the prescribed equipment
- The beneficiary has a diagnosis of temporomandibular joint (TMJ) dysfunction, and has received treatment for the TMJ condition; or,
- The beneficiary has distortion of the lower jaw or neck anatomy (e.g., radical neck dissection) such that a chin halter is unable to be utilized; or,
- The treating physician orders and/or documents the medical necessity for greater than 20 pounds of cervical traction in the home setting.
Diagnosis: See LCD (Local coverage determination) at CGSMedicare.com for any additional qualifying information questions, diagnosis codes and descriptions
Medicare approved detailed equipment descriptions for Cervical Traction
|Cervical traction, over door (HCPC-E0860)|
|Cervical traction, free standing with or without Pneumatic or air bladder (HCPC’s E0850, E0855, E0849)|
Patient notes/justification – Must be documented using your normal dictation process. Letter of medical necessity, notes wrote on letterhead or prescriptions are not valid.
Prescription/order requirements– Must contain Patient’s name, date of the order and Start date, detailed equipment description (See above), signature of the ordering physician and a signature date.