Home Health & Hospice Week

Companies decipher latest CMS edict while engineers head back to the lab.

The power mobility industry has had to swallow a lot of heavy policy changes this year, but a recent announcement from the Centers for Medicare & Medicaid Services has it complaining of indigestion.

In February, CMS released a plan that broke down the broad K0011 HCPCS code for power wheelchairs into 49 new, more specific codes. But last week, the agency announced that the codes and related testing standards need even more revisions to differentiate among various types of equipment. Meanwhile, the Jan. 1 implementation date remains.

"It's troubling that they would make this level of change this close to implementation," says Rita Hostak, vice president of government relations for Long-mont, CO-based Sunrise Medical. "It's causing a lot of confusion, a lot of chaos."

CMS says it must revise the classification and testing standards published in February to identify and differentiate among the different types of equipment.

For example, the testing requirements established for the "standard use" power chair placed the bar too high for some equipment and prevented the agency from making a meaningful distinction between categories based on durability and performance.

CMS has extended the product-testing deadline from Sept. 1 to Nov. 15 to give manufacturers more time to conduct tests under the new standards. The statistical analysis durable medical equipment regional carrier will make "every effort possible" to extrapolate testing results to determine proper code placement for products whose test results have already been submitted, CMS says. But manufacturers must test untested products--or those currently undergoing testing--according to the new guidelines.

Sunrise has already completed its testing, but the company feels obligated to ensure its products meet the new requirements, Hostak says.

"We're in the process of going through a 48-page document and trying to make sure we understand what all these changes are," she reports. "But the changes in the testing requirements are enough to make our engineers take a deep breath. I'm afraid it's going to take us a while to digest this." 

Note: More information is at www.palmettogba.com/sadmerc. Select "Coding Bulletins" under topics on the right hand side.