Page 24 - Mobility Management, August 2017

ATP Series
When CRT Goes Retail
Universal Elastic Strap
Like other Bodypoint supports, the machine wash/dry Universal Elastic Strap (UES) meets standards for abrasion and life-cycle testing for confident positioning anywhere. Choose from three widths (3", 4.5", 6"), each 56" long with an optional 28" exten- sion. The extension can also be used on its own, e.g. for pediatric lower-extremity anterior support.
The no-mount UES fastens hook-and-loop-style, using an easy- grasp end tab with an oversized thumb hole. Unlike makeshift belts, it protects circulation and skin integrity while providing stability. The cushioned neoprene with soft nylon loop fabric cuts to size without fraying and won’t snag clothes. Contrasting colors cue “right side out” instantly.
The UES can be wrapped around the user’s chest, core, upper or lower legs, where it can function on its own or wrap around a wheelchair, vehicle seat, stander, exerciser, bike, shower chair,
pool float/chair — anywhere extra support is needed.
Codes: E0978 if worn on pelvis, E0960 on chest, K0038 on
upper legs, E0995 around calves, but as temporary positioning, often self-paid.
Bodypoint
(800) 547-5716
bodypoint.com
Is Medicare’s Titanium Decision Just the Beginning?
In December, Medicare DME MAC and Pricing, Data Analysis
& Coding contractors made a “correct coding” announcement concerning manual wheelchairs with titanium frames and use of the K0108 “miscellaneous” HCPCS code.
“A recent review of K0108 identified increased billing for items that are characterized by titanium construction or heavy-duty packages constructed with titanium,” the announcement said. “The HCPCS codes for manual wheelchairs (K0001-K0009) were created in 1993 ... The Medicare fee schedule amount for these codes was established with the original code and included the cost of titanium-containing manual wheelchairs. Suppliers billing for manual wheelchair bases must not include HCPCS code K0108 in addition to the base wheelchair code when a wheelchair is constructed of titanium or for a ‘heavy duty package’ reflecting titanium construction materials.”
A Frame Is a Frame?
John Goetz, senior director of government affairs for Permobil, said the decision sharply restricts consumers’ access to titanium technology.
“To be very clear, nobody is asking Medicare to pay for this,” Goetz said. “We’re asking for Medicare to allow someone to purchase [the titanium upgrade] if they want to with their hard- earned money.”
The CMS argument is that the K0005 ultralightweight wheel- chair code and its allowable — created in 1993 — included payment for any type of wheelchair frame that might be used.
“[CMS] basically says that when they created the code and the corresponding fee schedule, they intended any material that [the frame] could be made of,” Goetz said. “So you can’t separately bill for titanium because the code and the allowable are supposed to [already] include those materials. They said when they created it, they anticipated all materials that it could be made out of, and the
24 AUGUST 2017 | MOBILITY MANAGEMENT
allowable should [already] cover that material cost.”
Josh Anderson, an ultralightweight wheelchair user and VP
of marketing for Permobil, says CMS’s announcement robs consumers of the ability to make their own choices.
“Limiting access to an upgrade is really the problem,” he said. “Even if you could afford it, you can’t get it because of the way things have been worded, that [titanium] just part of the frame.”
Titanium Today, but What’s Next?
Goetz noted that the new policy leaves little room for consumers to obtain that titanium upgrade.
“The only way is if you could get a dealer to take [the claim] completely unassigned,” he said. “Essentially, the end user would put out the entire cost of the wheelchair up front and wait for Medicare to pay them back for whatever the difference is. Not all dealers are willing to take unassigned [claims].”
An even bigger concern: Anderson believes the titanium deci- sion is just the start.
“I think they’re dipping their toes in the water,” he said of CMS. MobilityMgmt.com
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