Home Health & Hospice Week

Payment rates for these new codes not yet set.

The Centers for Medicare & Medicaid Services has established four new temporary K codes for adjustable wheelchair cushions, which could put money in your pocket faster.

Effective July 1, adjustable cushions previously coded under K0108 (Wheelchair component or accessory, not otherwise specified) will have their own, more specific codes, CMS says in a Feb. 3 transmittal. The new K codes include: • K0734 (Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth);

• K0735 (Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth);

• K0736 (Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth); and

• K0737 (Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth). Medicare may not reimburse you correctly for ordering or supplying these wheelchair cushions if you don't use the correct codes on your claim, CMS cautions in a Medlearn Matters article on the new codes.

A beneficiary can insert or remove air or gel in these adjustable cushions, says Paul Komishock, reimbursement department manager with Pride Mobility Products Corp. in Exeter, PA.

CMS determined in 2004 that these adjustable cushions didn't fit into the existing cushion categories of general use, skin protection, positioning or skin protection and positioning. So, the adjustable cushions were assigned to miscellaneous code K0108.

Good news: Now that these cushions have their own specific codes, the claims process for these products should speed up. Currently, when a claim with a K0108 code comes into a Medicare processing center, it must be reviewed by hand, says Komishock. When these new specific codes take effect this summer, Medicare can set up parameters that allow the claims to automatically process electronically, he says. That will work only when the claim includes all required information.

While billed under K0108, the adjustable cushions had a set allowable, which is unusual for a miscellaneous product, says Komishock. Whether these allowables will remain in place for the new codes remains to be seen; Medicare hasn't yet issued the fees for these codes, he adds. 

Note: The transmittal is at www.cms.hhs.gov/Transmittals/downloads/R835CP.pdf and the Medlearn Matters article is at http://new.cms.hhs.gov/MedlearnMattersArticles/downloads/mm4267.pdf.