CMS Clarifies E2378 Payment Status

A year ago - in November 2013 - the Centers for Medicare & Medicaid Services (CMS) made the controversial decision to move a large number of HCPCS codes from Medicare's routinely purchased payment status to capped-rental status.

That move came over concerns raised by DME and complex rehab technology stakeholders, who objected to the very old usage data being used to determine payment category status, and who worried that access to impacted equipment would be affected by the changes. In all, 78 codes were moved to the capped-rental category; 50 of those codes involved wheelchairs.

The final rule for the new payment categories went into effect April 1, 2014.

The single bit of good news from the final rule was that wheelchair accessories that were provided for use on complex rehab wheelchairs would remain in the routinely purchased category.

On Dec. 11, CMS clarified the status of one such HCPCS code: E2378, defined as "power wheelchair component, actuator, replacement only."

In its announcement, NHIC Corp. the jurisdiction A DME MAC, said the code "was missing from the list of items billable with complex rehabilitative wheelchair codes K0835-K0864."

The news announcement said, "Effective for dates of service on or after April 1, 2014, the E2378 is payable as a purchase when used with complex rehabilitative wheelchairs. If E2378 was denied incorrectly for being billed as a purchase, a reopening can be submitted for reprocessing."

About the Author

Laurie Watanabe is the editor of Mobility Management. She can be reached at lwatanabe@1105media.com.

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