NCART’s down but not out

Saturday, July 31, 2004

WASHINGTON - Seven power wheelchair codes proposed by the National Coalition for Assistive and Rehab Technology were preliminarily rejected by CMS for the 2005 HCPCS code update, said NCART’s Executive Director Sharon Hildebrandt.

“CMS rejected the codes saying some of our codes would fit within the K0011 and some would fit within the K0014,” said Hildebrandt. “They are telling us that the recommendations we make should fit into the K0011 code, yet [CMS] says there is a problem with the K0011 code. Their reasoning seems to be a little circular.”

NCART’s proposal called for the creation of seven power wheelchair “E” codes and the elimination of the contentious K-codes that have been in use since 1995. The codes were intended to “establish a code structure that adequately delineates among real consumer requirements and is ultimately reflected in real and relevant technology differences,” said the proposal.

Although the codes received a preliminary rejection prior to the HCPCS application meeting, held June 29-30, a CMS official said the codes would play a role in the agency’s efforts to revise the code set. CMS hopes to implement new power wheelchair codes by July 2005.

“At this time CMS is taking the initiative to look at the wheelchair coding,” said the official. “So, those recommendations that we got last year and again this year [from NCART] will be considered though that process.”

Last year, AAHomecare’s Rehab and Assistive Technology Council proposed dividing the K0010, K0011, K0012 and K0014 codes into six new codes. The proposal was rejected for the 2004 HCPCS update.

“At that time, the wheelchair issue was identified but we weren’t quite sure where we wanted to go or how to address problems with the wheelchairs,” said the official.

The industry has been calling for a coding revision to address the discrepancies between the existing K-code and the technology available. NCART has also pointed to new codes as necessary in curbing incidents of fraud and abuse.

NCART was able to make to make a 15-minute presentation to a CMS coding committee during the meetings in June. Final decisions from that meeting are not officially announced until the fall.

“Basically, we don’t believe that CMS understood the process the industry went through to come up with these codes,” said Hildebrandt. “We hope that by explaining what went into the codes we might be able to give them a better handle on the process.”