NGS Issues Reminder Regarding Denials for Anti-Tip Devices
National Government Services (NGS), the Jurisdiction B DME MAC, has issued a billing reminder regarding anti-tipping devices for power wheelchairs.
The Sept. 4 notification came, NGS said, as a result of supplier requests for redeterminations regarding denials for those anti-tips for power chairs.
“The Local Coverage Determination for Wheelchair Options and Accessories clearly indicates that anti-tipping devices are included in the allowance for power wheelchairs,” NGS said in the reminder. “Therefore, at the time of initial purchase of a power mobility device, anti-tipping devices should not be billed separately.”
NGS added, “The Health Care Common Procedure Coding System (HCPCS) describes code E0971 as a manual wheelchair accessory, anti-tipping device. Therefore, it would not be appropriate to bill HCPCS code E0971 when used with a power mobility device.”
Suppliers who need to replace anti-tipping devices that are currently on patient-owned, medically necessary power chairs could use K0108 — the miscellaneous options, accessories or replacement parts code — to bill Medicare, NGS said.
When filing those kinds of claims, NGS recommended suppliers add the RP modifier to the K0108 code; enter a description of the K0108 accessory needed in the NTE segment when filing an electronic claim; or use Item 19 of claim form CMS-1500 to “explain why the patient can no longer use the prior item (anti-tipping device) or why the item cannot be repaired” if the supplier is filing via a paper submission.
This article originally appeared in the November 2008 issue of Mobility Management.