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Lower Limb Prosthesis (LLP) Electronic Clinical Template

CMS is exploring the development of a list of suggested clinical elements for an electronic clinical template that will assist physicians with documenting the physician notes that substantiate the need for a Lower Limb Prostheses. This template may also facilitate the electronic submission of medical documentation. Visit the “Downloads” section and click on the “Lower Limb Prosthesis Suggested Electronic Clinical Template” link to view the document which describes the data elements that CMS believes would be useful in supporting the documentation requirements for coverage of Lower Limb Prosthesis. Comments on the document can be sent to

CMS hosted a series of Special Open Door Forum (SODF) calls in 2013 to allow physicians, prosthetists, and other interested parties to give feedback on the Suggested Electronic Clinical Template for Lower Limb Prostheses. CMS will work in collaboration with the DHHS Office of the National Coordinator for Health IT (ONC) and the electronic Determination of Coverage (eDoC) workgroup which is focused on developing the standards necessary for an electronic clinical template. Please continue to monitor this web page for more details on the updates to the clinical elements.