To support weak spinal muscles and/or a deformed spine.To reduce pain by restricting mobility of the trunk or.To facilitate healing following a surgical procedure on the spine or related soft tissue (see section on Post-operative Back Braces below) or.To facilitate healing following an injury to the spine or related soft tissues or.Lumbar Orthosis, Lumbar-Sacral Orthosis, and Thoracic-Lumbar-Sacral OrthosisĪetna considers a lumbar orthosis, lumbar-sacral orthosis, and thoracic-lumbar-sacral orthosis medically necessary for any of the following indications:. The following braces may be considered medically necessary for the listed indications when they are used to treat disease or injury. Certain orthopedic casts, braces and splints are covered under HMO plans without the DME rider because their use is integral to the treatment of certain orthopedic fractures and recovery after certain orthopedic procedures. Please check benefit plan descriptions for details. Standard Aetna HMO plans do not cover DME without a policy rider. Note: Most Aetna traditional plans cover durable medical equipment (DME) as a standard benefit. Number: 0009 Table Of Contents Policy Applicable CPT / HCPCS / ICD-10 Codes Background References
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