Kay Koch, OTR/L, ATP - Rehab Team Supervisor, The van Halem Group a division of VGM
Many times we are asked to review the Detailed Product Description (DPD) for a powered mobility device prior to authorization or ADMC review. There are items that may appear on the manufacturer’s quote for a powered mobility device but that are actually included in the base of the power chair.
Here’s a quick reference guide to assist you as you create your DPD’s. Sometimes, despite what is on the quote listed separately, Medicare will consider it “included.”
Basic Equipment Package
- Items that are part of a basic equipment package cannot be separately billed on an initial issue base.
- Basic equipment package for a POV:
- The battery or batteries required for operation
- Single-mode battery charger
- Weight-appropriate upholstery and seating system
- Tiller steering
- Non‐expandable controller with proportional response
- Complete set of tires
- All accessories needed for safe operation
- Basic equipment package for a PWC:
- Anterior pelvic support (lap belt, pelvic belt)
- Single-mode battery charger
- Complete set of tires and casters, including any type of tire
- Fixed, swing‐away or detachable non‐elevating legrests with or without calf pads
- Fixed, swing‐away or detachable footrests or a foot platform with or without angle adjustable footplates
- Fixed, swing‐away or detachable non‐adjustable height armrests with arm pads
- Any weight‐specific components required by patient weight
- Any seat width, seat depth and back width
- Non‐expandable controller with a standard proportional joystick (integral or remote)
- Sometimes if it’s not included, it CAN be separately billed on a PWC if it has been justified in the documentation:
- Shoulder harness or chest belt (E0978)
- Elevating legrests (ELR) or articulating legrests (ALR)
- Angle adjustable footplates on a Group 3 or 5 PWC
- Height adjustable armrests (E0973, K0020) unless provided on power tilt or recline
- The following seat and back dimensions if provided on a Group 3 or Group 4 PWC with a sling/solid seat/back:
- Seat width/depth or back width greater than 20" on a standard base
- Seat width/depth or back width greater than 22" on a heavy duty base
- Seat width/depth or back width greater than 24 " on a very heavy duty base
- No exceptions for extra heavy duty bases
- Expandable controller, a non‐standard joystick (non-proportional, mini, compact or short throw) or other alternative control device, if appropriate
- Standard joystick or any additional features of a joystick
- Electronic display box or hardware (included in E2310, E2311)
- Airless inserts
- Parts, pieces or materials used to construct custom seat (E2609) or custom back (E2617); all are included in the base code
- Multiple line items for headrest hardware
- Color options
- Performance packages
- Wheel locks
- Anti-tippers
- Back frame, seat frame, back posts
- Transit options
- Cannot charge for lateral trunk supports and hardware with E2620 or E2621 positioning back