You will be notified in writing whether a request has been approved or denied. Upper limb prosthetic Criteria/Exclusions PacificSource follows CMS NCD/LCD coverage guidelines. A doctor may recommend a knee scooter over crutches if injuries or surgical procedures are significant or if the leg requires elevation throughout the day. 
The department will review these requests in terms of medical necessity and department regulations. bottom: 20px; OL OL LI { The term home, for the beneficiary, is used to cover any of the following, Also Check: What Is The Annual Deductible For Medicare Part A, Aetna covers knee walkers in certain situations, Kneeling Walker/Knee Walker/RollingKnee Walker/ Kneeling Crutch. Aetna does not provide health care services and, therefore, cannot guarantee any results or outcomes. The wheels must be large enough and positioned such that the wheelchair could be propelled by the user. 
A Group 2 Multiple Power Option PWC is considered not medically necessary if criterion3.a. The individual's home should provide adequate access, maneuvering space and terrain for the operation of a POV. Furthermore, they will examine their developed system in individuals with upper mobility impairments. The anterior tilt seat function changes the seat angle orientation in relation to the ground in the sagittal plane and angles the seat forward. For example, each of the 10 standardized Medigap plansthat are available in most states provide at least partial coverage for the Medicare Part B coinsurance or copayments you typically have to pay for covered mobility scooters. Community Involvement
Three themes emerged in the follow-ups: perceived usefulness, barriers to use, and recommendations. To be eligible for repairs, a doctor must write you a new prescription that explains the medical need and why repairs to the scooter are necessary. JACO assistive robotic device: Empowering people with disabilities through innovative algorithms. The usual maximum medically necessary frequency of replacement for a lithium-based batteryis one every 3 years. } Best KL, Kirby RL, Smith C, MacLeod DA. A mobility limitation is one that: The members mobility limitation cannot be sufficiently and safely resolved by the use of an appropriately fitted cane or walker. The statement that an item may be separately billed does not necessarily indicate that it is considered medically necessary and covered. Texts will be strictly informational.
NHIC, Corp. Learn more in this blog. The face-to-face examination should provide information relating to the following: Aetna requires a specialty evaluation, as part of the face-to-face evaluation, for members who receive an ultralightweight manual wheelchair (MWC), Tilt-in Space MWC Group 2 Single power or Multiple Power Options Power Wheelchair (PWC), any Group 3 PWC, and power add on devices. One month's rental of a wheelchair is considered medically necessary if a member-owned wheelchair is being repaired. It may be able to accommodate power elevating legrests, seat elevator, and/or standing system in combination with a power tilt or power recline. First, think about the position in which one leg would sit on a scooter. 2021 Oct 9 [Online ahead of print]. One example of a proportional interface is a standard joystick. Since different states have different eligibility requirements, getting electric scooter Medicaid coverage may vary from state to state. Past history of or current pressure ulcer on the area of contact with the seating surface; Absent or impaired sensation in the area of contact with the seating surface or inability to carry out a functional weight shift due to one of the following diagnoses: spinal cord injury resulting in quadriplegia or paraplegia, other spinal cord disease, multiple sclerosis, other demyelinating disease, cerebral palsy, anterior horn cell diseases including amyotrophic lateral sclerosis, post polio paralysis, traumatic brain injury resulting in quadriplegia, spina bifida, childhood cerebral degeneration, Alzheimer's disease, Parkinson's disease,muscular dystrophy, hemiplegia, Huntington's chorea, idiopathic torsion dystonia, athetoid cerebral palsy, arthrogryposis, osteogenesis imperfecta, spinocerebellar disease or transverse myelitis. background-color: #cc0066; knee scooters are not covered by the plan, Top 10 Best Medicare Supplement Insurance Companies.
list-style-type: upper-roman; gell cell, absorbed glassmat), Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes, Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds, Power operated vehicle, group 1 heavy duty, patient weight capacity 301-450 pounds, Power operated vehicle, group 1 very heavy duty, patient weight capacity, 451-600 pounds, Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds, Power operated vehicle, group 2 heavy duty, patient weight capacity 301-450 pounds, Power operated vehicle, group 2 very heavy duty, patient weight capacity, 451-600 pounds, Power operated vehicle, not otherwise classified, Power wheelchair, group 1 standard portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds, Power wheelchair, group 1 standard portable, captains chair, patient weight capacity up to and including 300 pounds, Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds, Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds, Power wheelchair, group 2 standard portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds, Power wheelchair, group 2 standard portable, captains chair, patient weight capacity up to and including 300 pounds, Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds, Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds, Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301-450 pounds, Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity, 301-450 pounds, Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity, 451-600 pounds, Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity, 451-600 pounds, Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more, Power wheelchair, group 2 extra heavy duty captains chair, patient weight capacity 601 pounds or more, Power wheelchair, group 2 standard, seat elevator, sling/solid seat/back, patient weight capacity up to and including 300 pounds, Power wheelchair, group 2 standard, seat elevator, captains chair, patient weight capacity up to and including 300 pounds, Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds, Power wheelchair, group 2 standard, single power option, captain's chair, patient weight capacity up to and including 300 pounds, Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds, Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds, Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds, Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more, Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds, Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds, Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds, Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds, Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds, Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds, Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds, Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds, Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds, Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more, Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more, Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds, Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds, Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds, Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds, Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds, Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds, Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds, Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds, Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more, Power wheelchair, group 4 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds, Power wheelchair, group 4 standard, captains chair, patient weight capacity up to and including 300 pounds, Power wheelchair, group 4 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds, Power wheelchair, group 4 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds, Power wheelchair, group 4 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds, Power wheelchair, group 4 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds, Power wheelchair, group 4 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds, Power wheelchair, group 4 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds, Power wheelchair, group 4 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds, Power wheelchair, group 4 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds, Power wheelchair, group 4 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds, Power wheelchair, group 5 pediatric, single power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds, Power wheelchair, group 5 pediatric, multiple power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds, Power wheelchair, not otherwise classified, Power mobility device, not coded by DME PDAC or does not meet criteria, Combination sit to stand frame/table system, any size including pediatric, with seat lift feature, with or without wheels, Patient lift, fixed system, includes all components/accessories, Manual wheelchair accessory, lever-activated, wheel drive, pair, Shock absorber for manual wheelchair, each, Shock absorber for power wheelchair, each, Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each, Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each, Transport chair, adult size, patient weight capacity up to and including 300 pounds, Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds, Wheelchair accessory, crutch and cane holder, each, Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each, Wheelchair accessory, power standing system, any type, Power wheelchair accessory, electronic connection between wheelchair controller and one (or more) power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware, Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each, Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each, Elevating footrests, articulating (telescoping), each, Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each, Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each, Manual wheelchair accessory, wheel lock brake extension (handle), each, Manual wheelchair accessory, hand rim with projections, any type, each, No.2 footplates, except for elevating leg rest, Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each, Wheelchair accessory, calf rest/pad, each, Residual limb support system for wheelchair, any type, Wheelchair, pediatric size, not otherwise specified, Manual wheelchair accessory, handrim without projections (includes ergonomic or countoured), any type, replacement only, each, Manual wheelchair accessory, wheel lock assembly, complete, each, Wheelchair accessory, bearings, any type replacement only, each, Manual wheelchair accessory, pneumatic propulsion tire, any size, each, Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each, Manual wheelchair accessory, pneumatic caster tire, any size, each, Manual wheelchair accessory, tube for pneumatic caster tire, any size, each, Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, each, Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, each, Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, each, Manual wheelchair accessory, propulsion wheel excludes tire, any size, each, Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each, Manual wheelchair accessory, caster fork, any size, replacement only, each, Back, planar, for pediatric size wheelchair including fixed attaching hardware, Seat, planar, for pediatric size wheelchair including fixed attaching hardware, Back, contoured, for pediatric size wheelchair including fixed attaching hardware, Seat, contoured, for pediatric size wheelchair including fixed attaching hardware, Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware, Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware, Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware [not covered for enhanced joystick (e.g., Q Logic EX Joystick)], Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware, Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated, Power wheelchair accessory, chin cup for chin control interface, Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware, Power wheelchair accessory, breath tube kit for sip and puff interface, Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware, Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware, Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware, Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware, Power wheelchair component, drive wheel motor, replacement only, Power wheelchair component, drive wheel gear box, replacement only, Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only, Power wheelchair accessory, hand or chin control interface, compact, remote joystick, proportional, including fixed mounting hardware, Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only, Power wheelchair accessory, nonexpandable controller, including all related electronics and mounting hardware, replacement only, Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only, Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue, Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each, Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each, Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each, Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each, Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each, Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each, Power wheelchair accessory, caster fork, any size, replacement only, each, Cam release assembly, footrest or legrest, each, Rear wheel assembly, complete, with solid tire, spokes or molded, each, Rear wheel assembly, complete, with pneumatic tire, spokes or molded, each, Front caster assembly, complete, with pneumatic tire, each, Front caster assembly, complete, with semi-pneumatic tire, each, Front caster assembly, complete, with solid tire, each, Wheelchair accessory, wheelchair seat or back cushion, does not meet specific code criteria or no written coding verification from DME PDAC, Skin protection and positioning wheelchair seat cushion, Positioning wheelchair back cushion, posterior, Positioning wheelchair back cushion, posterior-lateral, Positioning wheelchair back cushion, planar back with lateral supports, Skin protection wheelchair seat cushion, adjustable, Skin protection and positioning wheelchair seat cushion, adjustable, Other and unspecified hereditary ataxia [spinocerebellar disease], Spinal muscular atrophy and related syndromes, Genetic torsion dystonia [idiopathic (torsion)], Degenerative disease of nervous system, unspecified [childhood cerebral degeneration], Demyelinating diseases of the central nervous system, Other and unspecified diseases of spinal cord, Pressure ulcer of contiguous site of back, buttock and hip, Congenital malformations of spinal cord, unspecified, Other congenital malformations of spine, not associated with scoliosis, Other and unspecified congenital malformations of musculoskeletal system, Intracranial injury [traumatic brain injury resulting in quadriplegia], Batteries (includes cleaning and testing), Power Wheelchair Base Groups 1 and 2 (K0813-K0843), Power Wheelchair Base Groups 3, 4, and 5 (K0848-K0891), Power tilt and/or recline seating systems (.
does medicaid cover knee scooters