Forty-nine codes are born

Monday, February 28, 2005

WASHINGTON - Medicare will expand the number of codes used for billing power wheelchairs from five to 49 and implement them on Jan. 1, 2006, CMS announced in early February.

Besides reflecting the range of power mobility products now on the market, more detailed coding will help facilitate getting the right products to patients and improve Medicare’s ability to pay suppliers appropriately, CMS stated upon releasing the codes Feb. 3.

In the early goings of evaluating the new codes, providers expressed mixed feelings and reservations.

“We’re still evaluating them, but we’re concerned that they may not accurately reflect current technology and that they may be cumbersome to apply,” said Sharon Hildebrandt, executive director of the National Coalition for Assistive Rehab Technology. “CMS doesn’t work in the field. They don’t know the technology and don’t apply it.”

NCART wants to make sure the codes reflect real-world needsand that they are flexible and accommodate a wide range of patients.

Matthew Burke, chairman of AAHomecare’s Rehab and Assistive Technology Council, called the codes a step in the right direction. The industry has been complaining for years that the current slate of five codes don’t adequately cover the market.

It will, however, take providers a while to get used to them, he said.

It’s critical, he added, that CMS develop appropriate allowables and have the new codes ready to go by the Jan. 1 deadline.

“The worse case scenario is that it is Jan. 1 and the DMERCs say the K0011 doesn’t work anymore but that they don’t have any allowables or code verifications,” Burke said.

That, he said, would be a billing nightmare.