Miscellaneous code rumors snuffed

Wednesday, April 30, 2003

ALEXANDRIA, Va. — Rampant rumors that new codes being developed for the rehab industry won’t include a miscellaneous code for parts and services are just that: rumors and nothing more.

Rita Hostak, chair of the Rehab and Assistive Technology Council (RATC) — the task force responsible for drafting the new coding system — said they have no plans to abolish the K0108 miscellaneous code and that it has just been a “rampant rumor.”

“There are too many odds and ends, especially in rehab, to get rid of that code,” Hostak said. “There are no plans to get rid of it. You just couldn’t.”

The K0108 is generally used by rehab providers to file claims on items that do not fall in any specific code. Items such as parts and services are typically filed under the miscellaneous code for reimbursement.

Tom McEnany, president of Wheelchair Plus in Jacksonville, Fla., said about 80 % of their claims use the K0108 due to the custom nature of the rehab industry. When dealing with parts, he said, there are so many types and so many varying prices that it is impossible to operate without the miscellaneous code.

“Take, for example, repair parts, you can go to the major providers of power wheel chairs. You can get a copy of a manual with their items in it. It’s two to three inches thick with thousands of parts. How can you code all that,” McEnany said.

Holland Medical in Kingsport, Tenn., also uses K0108 for a majority of their claims, said office manager Linda Laughner.

“We use it because with rehab equipment, the codes are so vague,” she said.

While certain rehab equipment does have its own alpha-numeric code, a large variety of the industry is custom, therefore leaving no specific code classification for products designed for one client.

“A lot of the codes are too general compared to the complexity of our products,” Laughner said. “You can’t use standard codes for custom rehab. It would be impossible.”

If the rumors were true and K0108 was eliminated, CMS would have a lot of questions to answer, said Kim Kaiser, president of New England Mobility in East Lyme, Conn.

“I would be on the phone to (CMS), tying up their phone lines even more,” he said. “It would be such a big problem because people would be calling up asking what’s the code for this and what’s the code for that.”

But Hostak said she is surprised to hear the rumor about the K0108 code and said the RATC even discussed assigning individual miscellaneous categories for a number of other products, like wheelchairs. “We thought about miscellaneous codes for different categories, but ultimately we did not submit anything.”

Hostak said the rumors probably started due to providers becoming nervous over using the national HCPCS codes once the Health Insurance Portability and Accountability Act (HIPAA) goes into effect in October 2003.

“It was probably just providers panicking,” she said. HME