Anthem Blue Cross Connecticut OR-PR.00006 Powered Robotic Lower Body Exoskeleton Devices Form
Procedure is not covered
This document addresses the use of powered, robotic lower body exoskeleton devices that may be utilized in the rehabilitation of or for daily use by individuals with neurological disorders that affect an individual’s ability to ambulate without assistance.
Note: For information regarding other prosthesis, please see the following:
- CG-DME-13 Lower Limb Prosthesis
- CG-OR-PR-08 Microprocessor Controlled Lower Limb Prosthesis
Position Statement
Investigational and Not Medically Necessary:
The use of a powered, robotic lower body exoskeleton device is considered investigational and not medically necessary under all circumstances, including but not limited to the following:
- To enable individuals with spinal cord injury to perform ambulatory functions; or
- To assist in the rehabilitation of individuals with spinal cord injury; or
- To assist in the rehabilitation of individuals with traumatic brain injury.