NC Medicare:
The only approved indication for this type of treatment is osteoarthritis of the knee as supported by one of the following ICD-9 codes that should submitted of the claim for this service:
715.16 Osteoarthrosis, localized, primary, lower leg
715.26 Osteoarthrosis, localized, secondary, lower leg
715.36 Osteoarthrosis, localized, not specified whether primary or secondary, lower leg
715.96 Osteoarthrosis, unspecified whether generalized or localized, lower leg