The AposTherapy System consists of a pair of shoe-like uppers with two convex units (Pertupods) on the sole of each device, a screw fixation mechanism for securely attaching the Pertupod to the track and, if required, soft spacers, weight discs, hard spacers, and wedge spacers. Separately marketed and commercially available off-the-shelf (OTS) gait analysis software is used by practitioners to inform their calibration of the biomechanical device. Based on a preliminary evaluation of pain, function, and activities of daily life, a personalized therapy program is created to meet the individual’s treatment needs using the personally calibrated device to help relieve pressure and pain from symptomatic joint and improve control of the muscular system and function. This is achieved by challenging the individual in a barely perceptible manner through the creation of micro-instability.
Practitioners use basic, OTS gait analysis software to collect measurements from various movements (e.g., velocity, step length, single limb support) as part of the treatment program. The individual’s progress is assessed periodically; the device is then further adjusted, and the therapy program updated as needed to achieve the predefined goals.
AposTherapy System may be considered medically necessary when ALL of the following criteria are met:
Use of AposTherapy System not meeting the criteria above will be considered not medically necessary.
AposTherapy System is considered not medically necessary with the presence of following:
97799 |
Covered Diagnosis Codes
M17.0 |
M17.10 |
M17.11 |
M17.12 |
M17.2 |
M17.30 |
M17.31 |
M17.32 |
M17.4 |
M17.5 |
M17.9 |
M25.561 |
M25.562 |
M25.569 |
R26.9 |
R26.89 |
Not Applicable
Internal Medical Policy Committee 5-19-2020 New policy
Current medical policy is to be used in determining a Member's contract benefits on the date that services are rendered. Contract language, including definitions and specific inclusions/exclusions, as well as state and federal law, must be considered in determining eligibility for coverage. Members must consult their applicable benefit plans or contact a Member Services representative for specific coverage information. Likewise, medical policy, which addresses the issue(s) in any specific case, should be considered before utilizing medical opinion in adjudication. Medical technology is constantly evolving and the Company reserves the right to review and update medical policy periodically.