Mobility Stakeholders: Code Descriptions Look Good, but Testing Requirement Worrisome

COLUMBIA, S.C.–The SADMERC’s 23-page Power Mobility Device
Coding Guidelines released last week provided the industry with
descriptions of CMS’ 64 new power wheelchair and scooter codes (see
HomeCare Monday, June 5).

While stakeholders said they were pleased with most of the new
details, they are still awaiting the release of additional
documentation to understand the full impact of the new codes.

“I think it’s a pretty good document. I’m actually impressed
with the thoroughness,” said Simon Margolis, vice president of
Franklin, Tenn.-based National Seating & Mobility. “It begins
to fill in some of our questions, and I think the real missing
issue now is the [local coverage determination].”

Cara Bachenheimer, vice president, government relations for
Elyria, Ohio-based Invacare Corp., said that “in general, the code
structure appears good. While the PMD code companion document
provides significantly more details regarding the code
specifications, it is still difficult to make an assessment in the
absence of the yet-to-be released DMERC medical policies and the
fee schedules relating to the new codes,” she said.

Bachenheimer did note one part of the document, however, that
has caused some unease: “We are quite concerned about the new
requirement that independent testing labs perform the testing when
we have already invested in extensive testing apparatus, and will
need to continue to conduct internal testing for non-Medicare
purposes. This will only add unnecessary costs to the system.”

According to the guidance document, manufacturers will have at
least one year to retest devices in an independent testing
facility, using the SADMERC’s new testing criteria.

Margolis said the requirement is unrealistic, and that the cost
would be exorbitant for manufacturers.

“That’s a significant problem. There aren’t enough independent
labs in the country to test [this equipment],” he said, adding that
most major manufacturers already have their own testing facilities.
“I don’t see the point of forcing manufacturers to go to a lab that
would be less sophisticated than their own.”

Margolis suggested the possibility of certifying manufacturers’
labs, and said he hoped “we’ll be able to figure out ways to make
an acceptable compromise for the industry.”

Test details will be published in an upcoming notice, the
SADMERC said.

This is the third time within the past two years that the
mobility codes have been reworked. With 61 specific codes for power
mobility devices and three additional miscellaneous codes, this new
code set is scheduled to take effect Oct. 1.

To view the new coding guidelines, click here.