Local Coverage Determination · DME MAC
L33823
Cervical Traction Devices
Version 26. CMS effective date 01/01/2020. CMS updated 02/13/2020. Read from the CMS Coverage API on 2026-10-13. Contractors on the report: CGS Administrators (DME MAC) and Noridian Healthcare Solutions (DME MAC).
CMS coverage policy citation. CMS Manual System, Pub. 100-3, Medicare National Coverage Determinations Manual, Chapter 1, Section 280.1
Coverage indication
In addition to the “reasonable and necessary” criteria contained in this LCD there are other payment rules, which are discussed in the following documents, that must also be met prior to Medicare reimbursement: The LCD-related Standard Documentation Requirements Article, located at the bottom of this policy under the Related Local Coverage Documents section. The LCD-related Policy Article, located at the bottom of this policy under the Related Local Coverage Documents section. Refer to the Supplier Manual for additional information on documentation requirements. Refer to the DME MAC web sites for additional bulletin articles and other publications related to this LCD. For the items addressed in this LCD, the “reasonable and necessary” criteria, based on Social Security Act § 1862(a)(1)(A) provisions, are defined by the following coverage indications, limitations and/or medical necessity. Cervical traction devices (E0840, E0849, E0850, E0855 and E0860) are covered only if both of the following criteria are met: The beneficiary has a musculoskeletal or neurologic impairment requiring traction equipment; and The appropriate use of a home cervical traction device has been demonstrated to the beneficiary and the beneficiary tolerated the selected device. If criteria 1 and 2 are not met, cervical traction will be denied as not reasonable and necessary. Cervical traction applied via attachment to a headboard (E0840) or a free-standing frame (E0850) has no proven clinical advantage compared to cervical traction applied via an over-the-door mechanism (E0860).
Excerpt from the LCD indication. Full text on CMS.
Documentation requirements
Items covered in this LCD have additional policy-specific requirements that must be met prior to Medicare reimbursement. Refer to the LCD-related Policy article, located at the bottom of this policy under the Related Local Coverage Documents section for additional information.
Related articles
- A55426 · Standard Documentation Requirements for All Claims Submitted to DME MACs
- A52476 · Cervical Traction Devices - Policy Article
Related NCDs
- NCD 280.1 · Durable Medical Equipment Reference List (version 4)
HCPCS codes on this LCD
5 other Level II codes are on the LCD and are not given a page in this set: E0849, E0850, E0855, E0856, E0860.
Questions
What does LCD L33823 cover?
L33823 is Cervical Traction Devices. It is a current final DME MAC local coverage determination, version 26.
Where is the CMS source for L33823?
The Medicare Coverage Database page for LCD L33823 version 26.
Get the signed answer via API
The signed answer is the receipt for this code on a date of service: the rule that was in force, with a hash you can replay. The call needs an API key. The source archive and as-of resolution are public.
curl -H "X-API-Key: $VERZI_API_KEY" \
"https://api.verzi.health/v1/rules/warrant?hcpcs=E0840&as_of=2024-01-15&npi=1234567890&state=UT"