Anthem Blue Cross Connecticut CG-MED-54 Strapping Form

This document addresses the use of strapping, strategically applying overlapping layers of adhesive plaster or tape to a specific area of the body for the purpose of applying pressure and holding that body part in place. Strapping is intended to partially immobilize or restrict movement in order to provide support to the identified body part.

Note: This document does not address elastic therapeutic tape (such as Kinesio^™ taping).

Clinical Indications

Medically Necessary:

Strapping is considered medically necessary for the treatment of injuries, illness or post-operative care in any of the following indications:

• Hand; or
• Finger; or
• Ankle; or
• Foot; or
• Toe.

Not Medically Necessary:

Strapping is considered not medically necessary for all other indications.