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.
