NCART Releases Funding Guide for Standing Devices

• By Laurie Watanabe
• Jun 13, 2013

NCART's Standing Device Workgroup has introduced a new resource for clinicians, providers and consumers seeking advice on securing funding for standing equipment.

The NCART Standing Device Funding Guide is available for download on NCART's Web site.

The guide covers a range of standing technology, from traditional standing frames (HCPCS code E0638) to sit-to-stand systems with seat lift features (K0637); multi-position (E0641) and mobile (E0642) standing frame/table systems; and manual and power chair standing system accessories (E2230 and E2301, respectively).

The guide takes clinicians and ATPs step by step through the client evaluation and the documentation process, beginning with a therapist or physician determining medical necessity for a standing program. If the client qualifies medically for a standing program, the guide next helps healthcare professionals to determine which type of standing device would be most appropriate.

The third step is to prepare documentation to support the claim for standing equipment. The funding guide makes suggestions regarding the data and details to include in the client's letter of medical necessity.

The guide also includes information on the claims and appeals processes, including options if the claim is denied.

The workgroup developed and included an evaluation worksheet that outlines the types of information typically helpful in the medical justification process for standing. For instance, the worksheet asks Functional Status questions on the client's ambulation and transfer abilities, as well as activities of daily living, living environment, transportation and cognitive levels. A section on the client's physical status includes information on sitting balance, muscle strength and unsupported sitting posture.

Members of the workgroup that developed the guide are Don Clayback, executive director, NCART; Nancy Perlich, COTA, ATP, reimbursement specialist, Altimate Medical; Kimberly Hanson, regional director of reimbursement, Ottobock; Amy Morgan, PT, ATP, national clinical education manager, Permobil; Mary Wilson Boegel, RRTS, president, Prime Engineering; Joe Keiderling, executive VP, Rifton; Andy Hicks, ATP, SMS, CAPS, western regional manager, Snug Seat; Rita Hostak, VP of government relations, Sunrise Medical; Ginny Paleg, PT, MPT, DScPT; Lew Golinker, attorney, Assistive Technology Law Center; and Garth Corbett, attorney, Disability Rights Texas.