Repairs: New billing policy 'will affect access'

Tuesday, March 31, 2009

BALTIMORE - Few providers consider wheelchair repairs a profit center, but the business will soon become even less attractive, they say.

On April 1, providers must start billing for repairs using standardized labor times. With each allowed unit of service representing 15 minutes of labor, they're now allowed to bill two units to repair or replace a battery on any power wheelchair; one unit to repair or replace each wheel or tire on any power or manual wheelchair; and so on.

But repairs aren't that black and white, providers say.

"It doesn't always take 15 minutes to change a tire," said Don Whitney, operations manager at Inland Medical and Rehab in Spokane, Wash. "I have techs in the back right now who have been working on replacing the tires on a wheelchair for an hour and a half because one of the tires has seized on the gear box."

CMS's "Repair Labor Billing and Payment Policy" outlines a table of allowed units for 14 different repairs and replacements, mostly for power and/or manual wheelchairs, and a new code (K0739: repair or non-routine service for durable medical equipment other than oxygen requiring the skill of a technician).

The new policy will affect complex rehab providers the most. For a wheelchair with tilt and recline, for example, providers often have to disassemble part of the chair just to get to the battery, they say.

"Complex wheelchairs are a lot more work," said Ron Reed, owner and CEO of Benchmark Mobility in Indianapolis.

Additionally, providers say CMS's table of repairs and replacements is too simplistic.

"There are a lot of things that aren't on there," said Rick Perrotta, president of Network Medical Supply in Charlotte, N.C. "What if you have to replace a foot platform? Or a seat? None of that is listed."

In the end, patients will suffer, providers say.

"It's going to affect access," Whitney said. "We've built our business on repairs, since so many providers don't do them. We take on a lot of patients in our area, especially those who bought wheelchairs from the 1-800 companies. It's frustrating."

The new policy may be shortsighted, but some providers can see the logic behind using standardized labor times.

"It kind of makes sense, when you think about it," Perrotta said. "When you bring your car into the shop to replace the brakes, there's a book that lists the labor time."