Another power wheelchair/Prosthesis question
Sean Saunders
Description
Collection
Title:
Another power wheelchair/Prosthesis question
Creator:
Sean Saunders
Date:
7/23/2013
Text:
Hello all,
I know we have had some recent discussions about providing a patient that
has a power wheelchair with prostheses but it seems to have some
conflicting information from other sources.
In the September 2011 O and P Almanac it states that the Medicare policy
has been changed and now allows for both to be provided. The responses
that were sent out on July 3 from a similar question here on the board
overwhelmingly indicated that it would not be a covered service.
We have a bilateral BKA that has ill fitting prostheses that we would like
to get replaced but are not sure how to proceed as he recently got a power
chair. He did walk into our facility with just a cane and is independent
with transfers so we can easily make a claim that he is at least a K2
ambulator.
Has anyone dealt with Medicare recently with a patient that has a power
chair and get coverage or are most just declining due to lack of
reimbursement in the past?
I did contact Medicare and of course they state they can not guarantee
payment but there is nothing specifically in place that would deny a
patient both devices but if it was audited (and we know how that's been
going) it is possible for it to be denied because the primary reason for a
power chair is that they are non-ambulatory.
Sorry for rehashing this subject and thanks for any help you can provide.
Sean Saunders
I know we have had some recent discussions about providing a patient that
has a power wheelchair with prostheses but it seems to have some
conflicting information from other sources.
In the September 2011 O and P Almanac it states that the Medicare policy
has been changed and now allows for both to be provided. The responses
that were sent out on July 3 from a similar question here on the board
overwhelmingly indicated that it would not be a covered service.
We have a bilateral BKA that has ill fitting prostheses that we would like
to get replaced but are not sure how to proceed as he recently got a power
chair. He did walk into our facility with just a cane and is independent
with transfers so we can easily make a claim that he is at least a K2
ambulator.
Has anyone dealt with Medicare recently with a patient that has a power
chair and get coverage or are most just declining due to lack of
reimbursement in the past?
I did contact Medicare and of course they state they can not guarantee
payment but there is nothing specifically in place that would deny a
patient both devices but if it was audited (and we know how that's been
going) it is possible for it to be denied because the primary reason for a
power chair is that they are non-ambulatory.
Sorry for rehashing this subject and thanks for any help you can provide.
Sean Saunders
Citation
Sean Saunders, “Another power wheelchair/Prosthesis question,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/235326.
