Ohio Admin. Code 5160-10-35 - DMEPOS: cranial remolding devices
(A)
No particular
form or format is specified for the certification of medical
necessity.
(1) Positional (non-synostotic)
plagiocephaly:
(a) The individual is at least
three months old but not older than eighteen months;
(b) Any of the following asymmetries is
present:
(i) A right/left discrepancy in the
skull base of at least six millimeters, measured subnasally to the
tragus;
(ii) A right/left
discrepancy in the cranial vault of at least ten millimeters, measured from the
frontozygomaticus point to the euryon; or
(iii) A right/left discrepancy in the
orbitotragial distances of at least four millimeters; and
(c) The asymmetry has not substantially
improved after two months of conservative cranial repositioning therapy or
physical therapy.
(2)
Positional (non-synostotic) braciocephaly: The cephalic index (the ratio of the
maximum width of the head to its maximum length) is greater than ninety-one per
cent.
(3) Positional
(non-synostotic) scaphocephaly: The cephalic index is less than seventy-five
per cent.
(4) Synostotic deformity:
(a) The individual is not older than eighteen
months;
(b) Premature closing of
the cranial structures has been documented; and
(c) Surgery with post-operative remolding is
medically indicated.
Notes
Promulgated Under: 119.03
Statutory Authority: 5164.02
Rule Amplifies: 5164.02
Prior Effective Dates: 09/01/2011, 07/16/2018
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