2004 Medicare Billing Guidelines for Rehab Products

Transcription

1 2004 Medicare Billing Guidelines for Rehab Products This document provides correct coding guidelines in a descriptive format comparable to the appendix found in the Medicare guidelines for wheelchair options/accessories. Floor and ceiling fee schedule amounts are included in parentheses for reference. Manual Wheelchair Base (Codes under Includes cannot be billed separately from the manual wheelchair base when provided at the same time) E1161 Manual adult size wheelchair with tilt in space ($ $ ) E1231 Manual pediatric size wheelchair, tilt in space, rigid, adjustable with seating system ($ $0.00) E1232 Manual pediatric size wheelchair, tilt in space, folding, adjustable with seating system ($ $ ) E1233 Manual pediatric size wheelchair, tilt in space, rigid, adjustable without seating system ($ $ ) E1234 Manual pediatric size wheelchair, tilt in space, folding, adjustable without seating system ($ $ ) E1235 Manual pediatric size wheelchair, rigid, adjustable with seating system ($ $ ) E1236 Manual pediatric size wheelchair, folding, adjustable with seating system ($ $ ) E1237 Manual pediatric size wheelchair, rigid, adjustable without seating system ($ $ ) E1238 Manual pediatric size wheelchair, folding, adjustable without seating system ($ $ ) K0001 Standard wheelchair ($ $54.62 rental only) K0002 Standard hemi (low seat) wheelchair ($ $81.83 rental only) K0003 Lightweight wheelchair ($ $89.59 rental only) K0004 High strength, lightweight wheelchair ($ $ rental only) K0005 Ultra-lightweight wheelchair ($ $ ) K0006 Heavy-duty wheelchair ($ $ rental only) K0007 Extra heavy-duty wheelchair ($ $ rental only) K0009 Other manual wheelchair/base (determined on individual basis) Includes: E0981 Seat Upholstery, replacement ($ $47.15) E0982 Back Upholstery, replacement ($ $51.53) K0060 Steel hand rim, each ($ $27.75) K0061 Aluminum hand rim, each ($ $39.37) K0066 Solid tire, any size, each ($ $28.52) K0069 Rear wheel assembly, complete; with solid tire, spokes or molded, each ($ $99.92) K0070 Rear wheel assembly, complete; with pneumatic tire, spokes or molded, each ($ $183.16) K0071 Front caster assembly, complete; with pneumatic tire, each ($ $109.25) K0072 Front caster assembly, complete; with semi-pneumatic tire, each ($ $65.76) K0076 Solid caster tire, any size, each ($ $25.55) K0077 Front caster assembly, complete; with solid tire, each ($ $58.85) K0081 Wheel lock assembly, complete, each ($ $40.68) K0452 Wheelchair bearings, any type ($ $6.55) 2004 Invacare Corporation Page 1 of 5 Rev. 03/04 JHS

2 Power Wheelchair Base (Codes under Includes cannot be billed separately from the power wheelchair base when provided at the same time) K0010 Standard weight frame motorized/power wheelchair ($ $ ) K0011 Standard weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking ($ $ ) K0012 Lightweight, portable motorized/power wheelchair ($ $ ) K0014 Other motorized/power wheelchair base (determined on individual basis) Includes: E0971 Anti-tipping device, wheelchair ($ $65.75) E0981 Seat Upholstery, replacement ($ $47.15) E0982 Back Upholstery, replacement ($ $51.53) E2366 Battery charger, single mode ($ $263.62) E2367 Battery charger, dual mode ($ $419.08) K0051 Cam release assembly, footrest or leg rest, each ($ $52.61) K0081 Wheel lock assembly, complete, each ($ $40.68) K0090 Rear wheel tire for power wheelchair, any size, each ($ $76.18) K0091 Rear wheel tire tube other than zero pressure for power w/c, any size, each ($ $20.77) K0092 Rear wheel assembly for power wheelchair, complete, each ($ $243.13) K0094 Wheel tire for power base, any size, each ($ $49.50) K0096 Wheel assembly for power base, complete, each ($ $274.29) K0098 Drive belt for power wheelchair ($ $27.21) K0099 Front caster for power wheelchair, each ($ $80.91) K0452 Wheelchair bearings, any type ($ $6.55) Power Operated Vehicle (Codes under Includes cannot be billed separately from the POV when provided at the same time) E1230 POV (3 or 4 wheel non-highway) must specify brand name and model number. ($ $ ) Includes: All options and accessories Invacare Corporation Page 2 of 5 Rev. 03/04 JHS

3 Leg Elevation (Codes under Includes cannot be billed separately from the leg elevation system when provided at the same time) E1009 Addition to power seating system, mechanically linked leg elevation ($ $0.00) E1010 Addition to power seating system, power leg elevation ($ $ ) Includes: E0990 Elevating leg rest, complete assembly, each ($ $117.43) K0053 Elevating foot rests, articulating (telescoping), each ($ $102.01) K0195 Elevating leg rests, pair (for use with capped rental wheelchair base) ($ $21.07) Power Tilt and/or Recline Seating Systems (Codes under Includes cannot be billed separately from the seating system when provided at the same time) E1002 Power-seating system, tilt only ($ $ ) E1003 Power-seating system, recline only, without shear ($ $ ) E1004 Power-seating system, recline only, with mechanical shear ($ $ ) E1005 Power-seating system, recline only, with power shear ($ $ ) E1006 Power-seating system, combination tilt and recline ($ $ ) E1007 Power-seating system, combination tilt and recline, with mechanical shear ($ $ ) E1008 Power-seating system, combination tilt and recline, with power shear ($ $ ) Includes: E0973 Detachable armrest, adjustable height, complete assembly ($ $114.97) K0020 Fixed, adjustable height arm rest, pair ($ $46.46) K0023 Solid back insert, planar back, single density foam; attached with straps ($ $94.09) K0024 Solid back insert, planar back, single density foam; with adj. hook-on hardware ($ $111.39) K0051 Cam release assembly, footrest or leg rest, each ($ $52.61) E0973 Detachable armrest, adjustable height, complete assembly ($ $114.97) (Codes under Includes cannot be billed separately from the armrest when provided at the same time) Includes: 2004 Invacare Corporation Page 3 of 5 Rev. 03/04 JHS

4 E0990 Elevating leg rest, complete assembly, each ($ $117.43) (Codes under Includes cannot be billed separately from the elevating leg rest when provided at the same time) Includes: E2325 Sip and puff interface, non-proportional ($ $ ) (Codes under Includes cannot be billed separately from the sip and puff interface when provided at the same time) Includes: E1028 Manual swing away, retractable or removable mounting ($ $206.54) K0039 Leg strap, H style, each ($ $53.88) (Codes under Includes cannot be billed separately from the H-style leg strap when provided at the same time) Includes: K0038 Leg strap, each ($ $24.26) K0045 Foot rest, complete assembly ($ $56.62) (Codes under Includes cannot be billed separately from the foot rest when provided at the same time) Includes: K0046 Elevating leg rest, lower extension tube, each ($ $19.53) (Codes under Includes cannot be billed separately from the elevating leg rest, lower extension tube when provided at the same time) Includes: (Codes under Includes cannot be billed separately from the elevating leg rest, upper hanger bracket when provided at the same time) Includes: K0044 Foot rest, upper hanger bracket, each ($ $16.64) K0053 Elevating foot rests, articulating (telescoping), each ($ $102.01) (Codes under Includes cannot be billed separately from the elevating foot rests, articulating when provided at the same time) Includes: E0990 Elevating leg rest, complete assembly, each ($ $117.43) K0069 Rear wheel assembly, complete; with solid tire, spokes or molded, each ($ $99.92) (Codes under Includes cannot be billed separately from the rear wheel assembly with solid tire when provided at the same time) Includes: K0066 Solid tire, any size, each ($ $28.52) 2004 Invacare Corporation Page 4 of 5 Rev. 03/04 JHS

5 K0070 Rear wheel assembly, complete, with pneumatic tire, spokes or molded, each ($ $183.16) (Codes under Includes cannot be billed separately from the rear wheel assembly with pneumatic tire when provided at the same time) Includes: K0067 Pneumatic tire, any size, each ($ $40.91) K0068 Pneumatic tire tube, each ($ $5.88) K0071 Front caster assembly, complete, with pneumatic tire, each ($ $109.25) (Codes under Includes cannot be billed separately from the front caster assembly with pneumatic tire when provided at the same time) Includes: K0074 Pneumatic caster tire, any size, each ($ $36.00) K0078 Pneumatic caster tire tube, each ($ $9.60) K0072 Front caster assembly, complete, with semi-pneumatic tire, each ($ $65.76) (Codes under Includes cannot be billed separately from the front caster assembly with semi-pneumatic tire when provided at the same time) Includes: K0075 Semi-pneumatic caster tire, any size, each ($ $41.85) K0077 Front caster assembly, complete, with solid tire, each ($ $58.85) (Codes under Includes cannot be billed separately from the front caster assembly with solid tire when provided at the same time) Includes: K0076 Solid caster tire, any size, each ($ $25.55) K0090 Rear wheel tire for power wheelchair, any size, each ($ $76.18) (Codes under Includes cannot be billed separately from the rear wheel tire for power wheelchair when provided at the same time) Includes: K0091 Rear wheel tire tube other than zero pressure for power w/c, any size, each ($ $20.77) K0092 Rear wheel assembly for power wheelchair, complete, each ($ $243.13) (Codes under Includes cannot be billed separately from the rear wheel assembly for power wheelchair when provided at the same time) Includes: K0090 Rear wheel tire for power wheelchair, any size, each ($ $76.18) K0091 Rear wheel tire tube other than zero pressure for power w/c, any size, each ($ $20.77) K0096 Wheel assembly for power base, complete, each ($ $274.29) (Codes under Includes cannot be billed separately from the wheel assembly for power base when provided at the same time) Includes: K0094 Wheel tire for power base, any size, each ($ $49.50) K0095 Wheel tire tube other than zero pressure for each base, any size, each ($ $49.50) K0195 Elevating leg rests, pair (for use with capped rental wheelchair base) ($ $21.07 rental only) (Codes under Includes cannot be billed separately from the elevating leg rests when provided at the same time) Includes: 2004 Invacare Corporation Page 5 of 5 Rev. 03/04 JHS