CMS decides to delay implementing new PWC codes

Sunday, January 30, 2005

January 31, 2005

WASHINGTON - CMS no longer plans to implement new power wheelchair codes and allowables by July 1, but now considers Jan. 1, 2006 a more likely starting date, according to industry sources.
The delay is good news for manufacturers, especially large manufacturers, who would have had a difficult time performing all the necessary product testing that’s required before a product can be assigned to a new HCPCS code.
“July 1 was impossible, and I think the folks at CMS realized that,” said Cara Bachenheimer, Invacare’s vice president of government relations.
The delay also allows the industry additional time to comment on the codes,  and possibly influence how CMS calculates the allowables, according to sources.
Look for the new codes to be released sometime this spring, sources say.
In related news, CMS now plans to release a revised wheelchair CMN in conjunction with new coverage criteria, which is expected sometime in March. Previously, CMS intended to issue a revised CMN prior to developing the new criteria.
“It didn’t make a lot of sense,” said Seth Johnson, director of government affairs for Pride Mobility products. “In order to get the revised CMN approved, there would be a comment period, and by the time that comment period ended, the (new coverage criteria) would be released a few weeks later.”
When that happened, CMS would have to revise the just-revised CMN so that if reflected the new coverage criteria, which is expected rest on a definition of functional ambulation and not the current bed-or-chair-confined requirement.