Template for power wheelchairs holds promise

Friday, March 30, 2012

WASHINGTON - CMS's decision to develop a template to help physicians with documentation for power wheelchairs has been a long time coming, industry stakeholders say.

To say that providers, ever since CMS changed the documentation requirements for power wheelchairs in 2006, have struggled to get adequate documentation from physicians is a severe understatement, they say.

"I think it's a big step in the right direction," said Seth Johnson, vice president of government affairs for Pride Mobility Products. "The template is something that many in the industry have been advocating for for years."

CMS officials first announced the news during an Open Door Forum March 21. It plans to give more details on the template in a series of upcoming forums, the first of which is April 10. What we do know so far: The template will take the shape of a series of prompts or reminders in the electronic health record that physicians use during a face-to-face visit.

That's welcome news to stakeholders like Sylvia Toscano. She says the current documentation requirements are too complex, especially for physicians who don't prescribe mobility equipment every day.

"The requirements for documentation for power mobility devices consists of, between the NCD and LCD, more than 40 separate points," said Toscano, owner of Professional Medical Administrators, a billing and consulting firm in Boca Raton, Fla. "There's no way a physician is going to touch on 40 separate points during a face-to-face examination."

Besides helping providers get everything they need from physicians, stakeholders hope the template will take some of the subjectivity out of the determination process.

"There needs to be more objectivity brought to what medical criteria Medicare is looking to physicians to evaluate to make that coverage determination," Johnson said.

Moving forward, stakeholders, who know the devil is in the details, plan to work with CMS officials closely on the template.

"The fact that they're going to provide opportunity for industry to comment on it, along with physicians, is a positive sign," said Don Clayback, executive director of NCART. "We'll be paying close attention and will be providing specific feedback on it as we get more information."