Education pays off

Friday, March 31, 2006

Q. What is the best way to educate physicians on CMS's new documentation requirements for power wheelchairs? How can we ensure that physicians' records document medical necessity?
A. You must develop or obtain a condensed but thorough education guide for physicians and their office staff. The physician education guide should include the following information:
- Does the patient have a mobility deficit that prevents him/her from performing one or more mobility related activity of daily living in his home? If he does, will a piece of equipment less expensive than a power wheelchair solve the problem?
- For example, can the patient use a cane, walker, manual wheelchair or scooter to resolve the mobility deficit?
- Does the power wheelchair provide additional features that will allow the patient to perform his/her mobility related activities of daily living in his/her home?
The physician's new documentation responsibilities are:
- Conduct a face-to-face examination of the patient;
- Address the medical necessity questions or write an order for a PT/OT to address the questions (If it's the latter, physicians must review the PT/OT evaluation and either note discrepancies or concur with the evaluation. If they concur, they must note this in their patient's chart notes and retain a copy of the PT/OT evaluation in their patient's chart);
- Write a prescription for the power mobility device; and
- Send photocopies of everything you are responsible for to the supplier of the equipment as soon as possible.
Finally, explain to physicians and their staffs how important it is that they follow the coverage and documentation guides. Doing so will allow them to provide you with what you need to accurately and timely bill Medicare. In turn, that will enable you to provide their patients with the appropriate equipment.


Dan Fedor is general manager for education and compliance at Pride Mobility Products. Reach him at (800) 800-8586 or