Mixon defends K0011 utilization

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Saturday, May 31, 2003

ELYRIA, Ohio — In response to questions about K0011 utilization by CMS Administrator Tom Scully, Invacare CEO Mal Mixon argues that power wheelchairs are medically necessary for a growing portion of the population. In a letter to Scully dated April 4, 2003, Mixon pointed out that demographics, technology, consumer awareness and the HCPCS coding system have all contributed to growth in the category. Here are excerpts from Mixon’s letter:

Demographics

“The majority of HCPCS K0011 power wheelchair users fall into the 70+ age category…. The demographics for this particular age category have and are dramatically increasing.”

Technology/Development

“Five to ten years ago, there were very few power wheelchairs on the market that were appropriate for operation in the average American home... Over the last five or so years, manufacturers have produced power wheelchairs that from both a size and maneuverability perspective are now capable of being fully and easily used within a beneficiary’s home and require little, if any, structural modification of the dwelling... Therefore, while there previously were beneficiaries who could have benefited from a power wheelchair, Medicare would not cover these items because the products were not usable within the person’s home.”

Consumer Awareness

“Seniors have becoming increasingly aware of power wheelchair options available in the market. The internet, television and other information sources provide a variety of resources for beneficiaries to understand more about various home health care items, as well as sophisticated technology, that can improve a beneficiary’s quality of life.”

HCPCS Coding

“Currently, HCPCS code K0011 contains a wide variety of power wheelchairs — from products designed for senior mobility to high-end units to accommodate the complex needs of people with significant, permanent disabilities. Refinement of the HCPCS coding system will give CMS the information it needs to properly understand the appropriateness of senior mobility products.” HME

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