New seating codes bring grief to providers

Sunday, October 10, 2004

October 11, 2004

WASHINGTON - CMS knocked providers for a loop last week when it posted “unacceptable” allowables for some of its 19 new K codes for wheelchair back and seat cushions.
“I’m really concerned,” said Mathew Burke, chair of AAHomecare’s Rehab and Assistive Technology Council. “The margins for some of them are below acceptable ranges.”
Adding to provider grief, many of the products that were to receive a new K code and allowable by Oct. 1 have not yet been reviewed by the SADMERC. As a result, providers will not be able to supply them to beneficiaries.
“I’m still fuzzy,” said Scott Scobey, president of Low Country Mobility in Beaufort, S.C. “What are we supposed to bill for and how are we supposed to do it.”
In a Sept. 21 letter to CMS, AAHomecare wrote: “Many of the products that RATC members provide to Medicare beneficiaries have not yet been reviewed. Without the SADMERC review and approval of the commonly provided, medically necessary, and physician-prescribed seating components, providers will not able to provide this equipment after October 1, 2004.”
 “The idea of a career change becomes more and more urgent, not just a thought, but a reality,” said a provider grappling with the new codes. “It's not much fun anymore.”