Article Detail - JA DME

Posted December 15, 2011

Recently the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) received questions regarding correct coding and billing of POVs (K0800-K0808, K0812), specifically the basic safety equipment that is considered included in the initial issue of a POV.

The Power Mobility Device local coverage determination (LCD) and related policy article (PA) detail the basic equipment package included with initial issue for a POV. The PA states:

POV Basic Equipment Package - Each POV is to include all these items on initial issue (i.e., no separate billing/payment at the time of initial issue):

• Battery or batteries required for operation

• Battery charger, single mode

• Weight appropriate upholstery and seating system

• Tiller steering

• Non-expandable controller with proportional response to input

• Complete set of tires

• All accessories needed for safe operation

All accessories necessary for the operation of the POV are included in the reimbursement at the time of initial issue. This includes such items as safety belts, anti-tipper devices and braking mechanisms. There is no separate billing of these items even if the supplier incurs a separate charge for the items from the manufacturer. Claims for these items, when billed separately at initial issue, will be denied for unbundling.

For correct coding all POVs (K0800-K0808, K0812) must have all components listed in the POV Basic Equipment Package.

Suppliers should refer to the DME MAC Supplier Manual, LCD and related PA for additional coverage, coding and documentation requirements.