Complex rehab: Out of Round 2, but in demo

Wednesday, November 30, 2011

WASHINGTON - CMS announced Nov. 30 that it removed ultra lightweight manual wheelchairs, gimbaled ventilator trays, and push activated power assist devices from the standard wheelchair product category for Round 2. 

Industry stakeholders had worked to have these codes dropped from competitive bidding since the product categories were announced in August. 

In a bulletin to members, however, Peggy Walker, a billing and reimbursement adviser for The VGM Group's U.S. Rehab, stated that the exclusion of the codes is temporary and that K0005, E0986 and E1030 are expected to be part of future rounds of the program.

Also, specialty skin protection and positioning adjustable wheelchair cushions (E2622-E2625) will still be put out to bid.

In other complex rehab news, CMS stated Dec. 1 in a bulletin that the codes included in the seven-state prepay review/prior authorization demonstration for power mobility devices (PMDs) include:

All Group 2 complex rehabilitative power wheelchairs (K0835 through K0843);

All Group 3 complex rehabilitative power wheelchairs without power options (K0848 through K0855); and

Group 5 pediatric power wheelchairs (K0890-K0891).

Read more about the industry's efforts to get complex rehab codes dropped from Round 2 here.

Find a complete list of codes included in the PMD demonstration project here