Part B Insider (Multispecialty) Coding Alert
Suppliers Divide and Conquer Disputed Code
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Want to write your own codes? Build a big tent and invite everyone in. That's the approach the American Association for Homecare has taken in developing 20 new HCFA Common Procedural Coding System (HCPCS) codes for an application to the Centers for Medicare & Medicaid Services. The Coding Task Force of AAH's Rehab and Assistive Technology Council has involved suppliers and manufacturers in developing proposals for codes in alternative positioning, ambulatory products, bath safety, configured seating, manual wheelchairs, power wheelchairs and wheelchair accessories. For the powered-mobility codes, the council went outside AAH's members and posted online surveys to receive input from clinicians and assistive-technology suppliers. The council also collected feedback from five customers of each of the work-group's manufacturers. The power-wheelchair category proved the most controversial, as CMS Administrator Tom Scully spoke out about the growth of claims for power wheelchairs during an open-door forum. The group worried that submitting new power wheelchair codes would "overshadow the hard work put into the overall coding proposal," council chair Rita Hostak with Sunrise Medical wrote in a letter to suppliers. In the end, though, the group decided that fixing the single K0011 code for power wheelchairs was part of the solution to power-wheelchair utilization. The group decided to propose replacing the single code with six new codes for power wheelchairs, including codes for nonmodular power wheelchairs, general-purpose power wheelchairs, positioning modular power wheelchairs, and multi-functioning positioning modular power wheelchairs, according to Sharon Hildebrandt with AAH. Instead of a single vague K code for power wheelchairs, AAH hopes CMS will institute a series of codes that will make billing for the chairs easier and reduce accusations of fraud. AAH has designed the codes based on clinical indicators and the need for special features like tilting and special seating apparatuses
All local codes will become null and void in October under the Health Insurance Portability and Accountability Act, Hildebrandt says. So one way or another, CMS will need to come up with new codes to replace existing state-specific codes. AAH hopes its input will lead to codes that will become standardized across all payers.
Part B Insider (Multispecialty) Coding Alert
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