HME News: CGS launches manual wheelchair review

High strength, lightweight manual wheelchairs will be the subject of a service-specific prepayment review because of their high claims payment error rate, CGS, the Jurisdiction C DME MAC, announced Feb. 18.

Additional documentation required for K0004 claims may include: detailed written orders; medical records showing the beneficiary meets general manual wheelchair coverage criteria and one of the two K0004 code specific criteria; documentation of an assessment showing the beneficiary’s home can accommodate the wheelchair; delivery documentation; and copy of advance beneficiary notice.

Relevant medical records are physician notes, non-physician clinical notes and non-physician clinical evaluations showing the beneficiary’s condition meets coverage criteria. Those records may come from a physician’s office, hospital, nursing home or home health agency, according to the bulletin.

….
MedBill
HME Billing Service
Provider of Professional
HME Billing Services

HME Billing News Feed: http://medbill.net/feed/

DME Billing Services MedBill Twitter
DME Billing Service News
DME Billing Services MedBill Twitter

Retrieved From:
HMENews.com