CG-DME-52 Continuous Passive Motion Devices in the Home Setting Form

This document addresses the use of continuous passive motion devices in the home setting. Continuous passive motion refers to the use of a motorized device that is applied to an individual’s extremity to move the individual’s joint continuously and slowly through a predefined arc of motion. Continuous passive motion devices are available for the elbow, hand, knee, shoulder, and wrist joints and are typically used during the immediate postoperative period following joint surgery.

Clinical Indications

Not Medically Necessary:

Use of a continuous passive motion (CPM) device in the home setting is considered not medically necessary for all indications.