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Definition of “Ambulatory”

Bryan King

List Members:
I am seeking guidance on where to find some clarity of how Medicare defines “ambulatory”.  Independent standing transfers? Step quantity/quality?  I have a polio patient who is now non-ambulatory but needs a custom tibial fracture orthosis for management of a traumatic tib/fib fracture.  L4396, L4397, and L4398 are the only codes that specifically mention use for non-ambulatory patients.  I can make a case for the need for customization due to the extreme leg atrophy and for the therapeutic qualities of the hydrostatics of a fracture brace.  But, if coverage totally hinges on patient’s ambulatory status, none of that other stuff matters.  Thanks!Bryan King, CPO, LPO

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