Summary
Comprehensive gait analysis may be considered medically necessary as an aid in surgical planning in patients with gait disorders associated with cerebral palsy. Comprehensive gait analysis is considered investigational for other applications, including surgical planning for conditions other than gait disorders associated with cerebral palsy and postoperative evaluation of surgical outcomes and rehabilitation planning or evaluation for all conditions. Gait analysis that is not comprehensive is considered investigational.
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What to do
Action · 6 steps
01Bill comprehensive gait analysis as medically necessary only as an aid in surgical planning for patients with gait disorders associated with cerebral palsy.
02Comprehensive gait analysis for other applications, and gait analysis that is not comprehensive, is considered investigational.
03Comprehensive gait analysis must include a quantitative assessment of coordinated muscle function in a dedicated laboratory.
04Document that each service is medically necessary, because no payment is made for services not documented to be medically necessary.
05The listed codes are medically necessary only when the procedure is performed according to the Policy section.
06For Federal Employee Program subscribers, FDA-approved devices may be assessed on the basis of their medical necessity.
Codes mentioned
96000960019600296004G80.0G80.9
Original notice
Gait Analysis
bcbsms.com · Always check the source before changing claims.
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