US · guidance
NCD 280.12
Sykes Hernia Control
Indications and Limitations of Coverage
Based on professional advice, it has been determined that the sykes hernia control (a spring-type, U-shaped, strapless truss) is not functionally more beneficial than a conventional truss. Make program reimbursement for this device only when an ordinary truss would be covered. (Like all trusses, it is only of benefit when dealing with a reducible hernia). Thus, when a charge for this item is substantially in excess of that which would be reasonable for a conventional truss used for the same condition, base reimbursement on the reasonable charges for the conventional truss.
Cross Reference
Also see the Medicare Benefit Policy Manual, Chapter 15 §130.
History
Version 1
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-26
- Edition
- mcd-2026-08-26
- Content hash
89d57cacfc5da030a730199ed3f445e81425a0c8ab6823fc83ea27e2dd6948c9
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