Mobility codes still a mystery

Tuesday, January 31, 2006

BALTIMORE - The rehab industry still awaits an update from CMS on new mobility codes. The word on the street: The agency has selected a contractor to oversee the project.
By early January, CMS hadn't named the contractor publicly. The agency also hadn't named members to a coding panel that will help craft the new codes, according to industry sources.
The pressure is on, because several other important initiatives depend on the new codes. For example, the agency put the local coverage determination (LCD) on hold, so it can implement the LCD and codes at the same time.
Additionally, "allowables depend on codes, and you can't create codes without a coding panel," said Seth Johnson, director of government affairs for Exeter, Pa.-based Pride Mobility.
CMS in October delayed implementing 65 new codes on Jan. 1, 2006, to review input from stakeholders. The delay was good news for the industry, especially manufacturers, who were outraged when CMS blindsided them with the codes in September. Manufacturers had already tested products based on the 49 codes that CMS released in February 2005.
In the new codes, the industry would like to see three things, according to Cara Bachenheimer, vice president of government relations for Elyria, Ohio-based Invacare: codes that incorporate new technology; testing requirements that are consistent with industry standards; and codes that integrate clinical information.
On the latter, Bachenheimer said, "We'd like to have the codes be more indicative of the user populations they're intended for. That they're not just a description of technology."
The panel will likely include nine to 12 members representing a broad range of interests, including CMS, the SADMERC, engineers, clinicians, manufacturers and suppliers.