PSCs Publish FAQs on Power Mobility Devices, Repair & Replacement Issues

Two Program Safeguard Contractors — TriCenturion (Jurisdictions A & B) and TrustSolutions (Jurisdiction C) — have published frequently asked questions documents on power wheelchairs and scooters, and repair and replacement issues.

The repair and replacement document includes questions such as “Will Medicare pay for repairs to a piece of equipment that was obtained prior to the client being covered by Medicare?” and “For repairs, may travel time be charged using the A9900 procedure code for DME supply or A9270 non-covered service?” (Answers: 1. “The beneficiary must meet current Medicare reimbursement criteria for the equipment in order to be repaired if Medicare did not purchase the item. If it was obtained prior to Medicare coverage or if another payor purchased the equipment, the supplier must obtain the required documentation to verify coverage and to determine if the item is covered by a warranty.” 2. “Travel time is included in the reimbursement of parts and labor and MAY NOT be paid separately. If a supplier chooses to bill separately, code A9901 must be used. This code is autodenied as a CO denial. Code A9270 must not be used.”)

The power mobility device FAQ document covers whether the face-to-face order and detailed product description must always be two separate documents in an audit (short answer: Yes), and whether a supplier needs a new physician order if the physician has prescribed a power wheelchair, but an assessment reveals that the beneficiary qualifies only for a scooter (answer: Yes, but if the seven-element order had been more general and the physician had simply prescribed “power mobility device” instead of “power wheelchair,” then a new order would not be required if the detailed power description was sufficient to indicate physician agreement with a POV).

To download and read the FAQ documents, visit www.tricenturion.com/content/faq_dyn.cfm.

This article originally appeared in the November 2007 issue of Mobility Management.

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