Prosthetic Devices, Wigs, Specialized, Microprocessor or ...
Meets all of the criteria below: Has a microprocessor (swing and stance phase type (L5856)) controlled (electronic) knee K3 functional level only Weight greater than 110 lbs. and less than 275 lbs. Has a documented comorbidity of the spine and/or sound limb …
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www.uhcprovider.comThe benefit information in this Coverage Summary is based on existing national coverage ... Also see the Medicare Prescription Drug Benefit Manual,Chapter 6, ...
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