AOTA requests that the last sentence be modified to address acute conditions in which a patient may not be able to tolerate any procedures due to pain and muscle spasm associated with the acute inflammation.
As an alternative, AOTA suggests the following rewording:

This modality is generally used in conjunction with other therapeutic modalities and/or
procedures and not as an isolated treatment, except in acute conditions where the medical
necessity for mechanical traction as an isolated modality is clearly documented.


Vasopneumatic Devices (CPT code 97016)

Although certain patients may be taught to use vasopneumatic devices at home, it is not always clinically appropriate to do so. For example, a patient who has cardiopulmonary problems exacerbated by fluid retention may experience increased symptoms of congestive heart failure as a consequence of the use of a vasopneumatic device.

Or, a patient with a new amputation may need to have some edema reduction prior to prosthetic training by the occupational therapist. In these situations, the use of a vasopneumatic device is clinically appropriate and reference to having a clinical condition requiring skills and knowledge of a qualified clinician is misleading. It is the total treatment program for which the skills of a qualified clinician are needed.

For these specific reasons and the more general comment against “rules of thumb” guidance, AOTA requests that the reference to limiting coverage primarily for the purpose of educating the patient in the use of the pump be deleted. AOTA would not object to requiring documentation of objective evidence of clinical efficacy, such as reduced edema.