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2.7.3 Cranial Molding Orthotics
2.7.3.1 Services/Benefits and Limitations
Cranial molding orthotics may be a benefit when the following applies:
• The cranial molding orthotics are part of a treatment plan for shaping the skull in cases of post-operative plagiocephaly with synostosis or positional plagiocephaly with an associated functional impairment (or risk thereof).
• Documentation exists that the use of the cranial molding orthotic will modify or prevent the development of such impairment, including orofacial and musculoskeletal disorder, for clients who are 3 through 18 months of age.
Muscular torticollis (wry neck) characterized by tight or shortened neck muscles that result in a head tilt or turn is often associated with the secondary development of positional plagiocephaly. Clients with positional plagiocephaly and muscular torticollis must have documentation of early, aggressive treatment (stretching, positioning, or physiotherapy) before consideration for cranial orthosis.
Request for clients with a comorbid diagnosis that prohibits repositioning will be evaluated on an individual basis.
Cranial molding orthotics may be reimbursed using procedure code S1040.
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