Physician documentation: Industry continues fight for clarification

YARMOUTH, Maine - The rehab industry continues to lobby CMS and the medical carriers to issue further guidance on physician documentation requirements for power mobility devices. "We've been told that the local coverage determination is the best place to have that clarifying language," said Cara Bachenheimer, vice president of government relations for Invacare. The DMERCs won't release an LCD, however, until CMS releases new codes and sets a fee schedule. "If they don't implement new codes until January, we need clarification prior to that," said Seth Johnson, vice president of government affairs for Pride Mobility. CMS published its final rule for power mobility devices in the Federal Register April 5. The rule, which goes into effect June 5, 2006, replaces CMNs with physician prescriptions and medical records. Despite a seven-step process for writing prescriptions and a nine-step process for determining medical necessity, the industry argues both physicians and providers need further guidance on what should be included in medical records. While they wait, providers are forced to make do with what they have, much of which has come from manufacturers and various state associations and industry groups, sources said. "We've figured it out to the best of our capability and we've moved on," said Rick Perrotta, president of Network Medical Supply in Charlotte, N.C. "It'd be one thing if we were 20% mobility--then we'd just sit back and let the dust settle. But we're 100% mobility."