Cervical Traction

 
Cervical Traction
 
Cervical traction devices are covered only if both of the criteria below are met:
 

1. The patient has a musculoskeletal or neurologic impairment requiring traction equipment.
2.  
3. The appropriate use of a home cervical traction device has been demonstrated to the patient and the patient tolerated the selected device.
4.  

Cervical traction devices that attach to a headboard or a free-standing frame have no proven clinical advantage compared to cervical tractions attached to an over-the-door mechanism. If a traction device that uses a headboard or free-standing attachment is ordered and the medical necessity criteria for the device is met, payment will be based on the allowance for the least costly medically appropriate alternative, a device that attaches over a door.
 
Cervical traction devices that attach to a frame or stand are covered only when criteria 1 and 2 above and either criteria A, B or C below have been met:
 

• A patient has a temporomandibular joint (TMJ) dysfunction diagnosis and has received TMJ treatment.
• A patient has distortion of the lower jaw or neck anatomy such that a chin halter is unable to be utilized.
• A physician orders greater than 20 pounds of cervical traction in the home setting.

An order for each item billed must be signed and dated by the treating physician and kept on file by the supplier. Cervical traction items are typically purchased.