Review finds 80% error rate for power wheelchairs

Thursday, February 28, 2013

WASHINGTON – A prepayment review of power wheelchair claims processed in Jurisdiction B resulted in an 80% error rate, according to National Government Services (NSG), the DME MAC there. Of 1,022 claims processed from Oct. 1 2012­–Dec. 31, 2012, 122 were paid in full, while the remaining claims were completely or partially denied, according to the review. The most common reasons for denials were: Local Coverage Determination (LCD) criteria not met; face-to-face examination with a physician not established; and failure to prove that canes or walkers could not resolve mobility limitations inside the home.