Axillary Crutches

These are lengths of wood or aluminum tubing jointed in long narrow V shape. The wide end is padded and fits in the underarm of patient. These are usually used as a pair to support the body weight of someone with an injured leg or foot. Size/length of crutch is related to the standing height of patient.

HCPCS Code:

E0112 - (wood-pr)
E0113 - (wood-ea)
E0114 - (alum-pr)
E0116 - (alum-ea)

Category:

Inexpensive/Routinely Purchased

Common Diagnosis:

(check for current coding)

824.0 Ankle Fracture
825.0 Foot Fracture
820.00 Femur Fracture
343.9 Cerebral Palsy
719.4 Joint Pain

Coverage Information

Requires a detailed written order

The patient has impaired ambulation and there is a potential for ambulation.

• The patient has a mobility limitation that significantly impairs his/her ability to participate in one or more mobility-related activities of daily living (MRADL) in the home; AND

• The patient is able to safely use the cane or crutch; AND

• The functional mobility deficit can be sufficiently resolved by use of a cane or crutch

Documentation Requirements: in addition to the basic Medicare documentation (proof of delivery, AOB, detailed written order, etc.)

• The detailed written order form must contain the patient’s name, the start date of the order, and a description of the item.