Manual Wheelchairs

Coverage

Manual Wheelchairs Local Coverage Determination (LCD) and Policy Article [PDF]

Documentation

Clinician Letter - Medical Records [PDF] - Letter may be sent to clinicians to help obtain documentation
Manual Wheelchair Documentation Checklist [PDF] - Checklist to ensure suppliers gather all required documentation

Reviews/Audits

Medical Review - View notifications/findings of pre/post claim reviews completed by Noridian Medical Review

Tips

Topic	Details
ADMC (Review Type)	Manual wheelchairs described by HCPCS E1161, E1231 - E1234, K0005, K0008, and K0009 are eligible for ADMC
Criteria C (Review Type)	For manual wheelchairs, a home assessment may be provided directly, by visiting beneficiary's home, or indirectly, based upon information provided by beneficiary or his/her designee. When a home assessment is based upon indirectly obtained information, supplier must, at time of delivery, verify that item delivered meets requirements specified in criterion C. Issues such as physical layout of home, surfaces to be traversed and obstacles must be addressed by and documented in home assessment

Topic

Details

ADMC (Review Type)

Manual wheelchairs described by HCPCS E1161, E1231 - E1234, K0005, K0008, and K0009 are eligible for ADMC

Criteria C (Review Type)

For manual wheelchairs, a home assessment may be provided directly, by visiting beneficiary's home, or indirectly, based upon information provided by beneficiary or his/her designee. When a home assessment is based upon indirectly obtained information, supplier must, at time of delivery, verify that item delivered meets requirements specified in criterion C. Issues such as physical layout of home, surfaces to be traversed and obstacles must be addressed by and documented in home assessment

Last Updated Aug 20, 2018

The below are topic specific articles which have been published to "Latest Updates" and sent out in Noridian emails within the past two years. Exclusions to this include time sensitive related announcements such as: Noridian and CMS educational events, Ask-the-Contractor Teleconferences and claims processing downtime.