Reminder - Replacement of Power Mobility Devices

Original Effective Date: 11/05/2009
Revision Effective Date: 11/01/2013

Suppliers are reminded that replacement of power mobility devices (PMDs) under reasonable useful lifetime rules differ from other types of durable medical equipment. As detailed in Final Rule for Power Mobility Devices ( Federal Register, Vol. 71, No. 65, April 5, 2006) and published in the October 2007 Frequently Asked Questions – Power Mobility Devices article:

Q7. If a new PMD is needed after 5 years of use, what documentation must be obtained? Must we start the complete process or just obtain a new order?
A7. All new PMD requirements must be met. Many new products are available, the codes have changed, and a patient's functional status must be assessed through a face-to-face evaluation in order to establish need.

When replacing a PMD after the 5 year reasonable useful lifetime is met, the beneficiary must meet all of the coverage requirements outlined in the local coverage determination (LCD) for PMDs, including a new 7-element order and face-to-face evaluation. Claims that do not meet the coverage, coding or documentation criteria will be denied.

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