Myoelectric Upper Extremity Prosthetic Device Policy
Effective November 18, 2021, Anthem Blue Cross considers a Partial Hand Myoelectric Prostheses (e.g. i-Limb Digits) a covered benefit when medical necessity is documented.
Effective November 18 2021, Anthem Blue Cross considers Myoelectric Upper Extremity Prosthetic Devices and Partial Hand Protheses as medically necessary when the following criteria is documented in the medical records:
- Absence of arm/portion of arm
- Patient has cognitive ability to learn and operate the technology
- Body powered devices cannot meet functional needs
- The remaining muscles of the arm contains minimum microvolt threshold
- A multidisciplinary assessment required
What Does This Mean for You?
The above criteria must be documented in the patient’s medical record along with any assessment results and/or corroborating documentation from other healthcare practitioners.
Medicare and several other large payers currently consider multi-articulating digits to be medically necessary under same or similar conditions as mentioned above
You may read the full policy HERE »
If you have further questions about the coverage requirements, contact us directly at [email protected] for more assistance.