Providing Items Prior to Surgery

  • Determining need prior to surgery - Items can be provided and billed prior to surgery when item is medically necessary and the brace is required to be worn prior to surgery, coverage criteria is met, and documentation to substantiate the need is included in ordering physician’s medical record.
  • Determining need after surgery - If there is no medical need to wear the item until after surgery, item should not be provided until after the surgery has been performed and medical need is clearly established per Medicare guidelines.


Last Updated Oct 25 , 2022