Re: Stand-alone Wheelchair Evals

[Guest guest]

Ron,

Requests for wheelchair evals are not that uncommon and should be handled

like any other specialty eval including getting a physician's order prior to

the evaluation. I usually put this task on the DME provider or client who

is requesting the service. These specialty evaluations meet the Medicare

creiteria for coverage of showing a medical necessity and requiring skilled

professional services. The coding and billing of it is specific to the

payers. We met with our local Medicare Director at the time and were

instructed to bill and code one way where our BCBS affliate instructed us to

use different codes for this service.

Aloha

Lockette PT

www.ohanapacificrehab.com

Stand-alone Wheelchair Evals

> Does anyone receive requests from DME's to perform power w/c evals on a

> patients that are not currently receiving therapy? How do you handle

> these situations?. For example, do you call the doctor's office and

> request a script prior to doing the eval? Do you do the eval without a

> script and just send the patient's doctor a copy of the eval?

>

> To me, this seems to be a gray area. Medicare has all but mandated a

> therapy evaluation for power wheelchairs, but I can not find any

> documentation clearly delineating the procedural aspects of a one-time

> therapy evaluation for a power wheelchair.

>

> Thanks,

>

> Ron C.

>

>

>

>

>

> Looking to start your own Practice?

> Visit www.InHomeRehab.com.

> Bring PTManager to your organization or State Association with a

professional workshop or course - call us at 313 884-8920 to arrange

> PTManager encourages participation in your professional association. Join

and participate now!

>

[Guest guest]

Ron,

Requests for wheelchair evals are not that uncommon and should be handled

like any other specialty eval including getting a physician's order prior to

the evaluation. I usually put this task on the DME provider or client who

is requesting the service. These specialty evaluations meet the Medicare

creiteria for coverage of showing a medical necessity and requiring skilled

professional services. The coding and billing of it is specific to the

payers. We met with our local Medicare Director at the time and were

instructed to bill and code one way where our BCBS affliate instructed us to

use different codes for this service.

Aloha

Lockette PT

www.ohanapacificrehab.com

Stand-alone Wheelchair Evals

> Does anyone receive requests from DME's to perform power w/c evals on a

> patients that are not currently receiving therapy? How do you handle

> these situations?. For example, do you call the doctor's office and

> request a script prior to doing the eval? Do you do the eval without a

> script and just send the patient's doctor a copy of the eval?

>

> To me, this seems to be a gray area. Medicare has all but mandated a

> therapy evaluation for power wheelchairs, but I can not find any

> documentation clearly delineating the procedural aspects of a one-time

> therapy evaluation for a power wheelchair.

>

> Thanks,

>

> Ron C.

>

>

>

>

>

> Looking to start your own Practice?

> Visit www.InHomeRehab.com.

> Bring PTManager to your organization or State Association with a

professional workshop or course - call us at 313 884-8920 to arrange

> PTManager encourages participation in your professional association. Join

and participate now!

>

[Guest guest]

Ron,

Requests for wheelchair evals are not that uncommon and should be handled

like any other specialty eval including getting a physician's order prior to

the evaluation. I usually put this task on the DME provider or client who

is requesting the service. These specialty evaluations meet the Medicare

creiteria for coverage of showing a medical necessity and requiring skilled

professional services. The coding and billing of it is specific to the

payers. We met with our local Medicare Director at the time and were

instructed to bill and code one way where our BCBS affliate instructed us to

use different codes for this service.

Aloha

Lockette PT

www.ohanapacificrehab.com

Stand-alone Wheelchair Evals

> Does anyone receive requests from DME's to perform power w/c evals on a

> patients that are not currently receiving therapy? How do you handle

> these situations?. For example, do you call the doctor's office and

> request a script prior to doing the eval? Do you do the eval without a

> script and just send the patient's doctor a copy of the eval?

>

> To me, this seems to be a gray area. Medicare has all but mandated a

> therapy evaluation for power wheelchairs, but I can not find any

> documentation clearly delineating the procedural aspects of a one-time

> therapy evaluation for a power wheelchair.

>

> Thanks,

>

> Ron C.

>

>

>

>

>

> Looking to start your own Practice?

> Visit www.InHomeRehab.com.

> Bring PTManager to your organization or State Association with a

professional workshop or course - call us at 313 884-8920 to arrange

> PTManager encourages participation in your professional association. Join

and participate now!

>

[Guest guest]

Our OT staff does many power w/c evals referred from the DME company across the

street. We call the physician, request a script then call to schedule the pt.

for an eval, which generally is their only visit unless we identify other

therapy needs (for which we request another " eval and tx " script). Usually the

DME rep has been to the client's home to do their assessment and comes to the OT

eval with THEIR equipment recommendations. We then go through them and make

sure that the equipment meets the pt's needs from a therapy perspective. We

just bill the eval's as usual, even though they are time consuming (especially

if they are medicaid). Feel free to e-mail me directly if you have further

questions.

Kathleen Fulger, OTR/L

Supervisor, Occupational Therapy

Fisher-Titus Medical Center

Ext. 1917

kfulger@...

Stand-alone Wheelchair Evals

Does anyone receive requests from DME's to perform power w/c evals on a

patients that are not currently receiving therapy? How do you handle these

situations?. For example, do you call the doctor's office and request a

script prior to doing the eval? Do you do the eval without a script and just

send the patient's doctor a copy of the eval?

To me, this seems to be a gray area. Medicare has all but mandated a therapy

evaluation for power wheelchairs, but I can not find any documentation

clearly delineating the procedural aspects of a one-time therapy evaluation for

a power wheelchair.

Thanks,

Ron C.

Looking to start your own Practice?

Visit www.InHomeRehab.com.

Bring PTManager to your organization or State Association with a professional

workshop or course - call us at 313 884-8920 to arrange PTManager encourages

participation in your professional association. Join and participate now!

[Guest guest]

Our OT staff does many power w/c evals referred from the DME company across the

street. We call the physician, request a script then call to schedule the pt.

for an eval, which generally is their only visit unless we identify other

therapy needs (for which we request another " eval and tx " script). Usually the

DME rep has been to the client's home to do their assessment and comes to the OT

eval with THEIR equipment recommendations. We then go through them and make

sure that the equipment meets the pt's needs from a therapy perspective. We

just bill the eval's as usual, even though they are time consuming (especially

if they are medicaid). Feel free to e-mail me directly if you have further

questions.

Kathleen Fulger, OTR/L

Supervisor, Occupational Therapy

Fisher-Titus Medical Center

Ext. 1917

kfulger@...

Stand-alone Wheelchair Evals

Does anyone receive requests from DME's to perform power w/c evals on a

patients that are not currently receiving therapy? How do you handle these

situations?. For example, do you call the doctor's office and request a

script prior to doing the eval? Do you do the eval without a script and just

send the patient's doctor a copy of the eval?

To me, this seems to be a gray area. Medicare has all but mandated a therapy

evaluation for power wheelchairs, but I can not find any documentation

clearly delineating the procedural aspects of a one-time therapy evaluation for

a power wheelchair.

Thanks,

Ron C.

Looking to start your own Practice?

Visit www.InHomeRehab.com.

Bring PTManager to your organization or State Association with a professional

workshop or course - call us at 313 884-8920 to arrange PTManager encourages

participation in your professional association. Join and participate now!

[Guest guest]

,

Let me get this straight, you don't feel that a referral from a salesperson is a

conflict of interest? I can understand your argument regarding the elimination

of the need for a referral, but that situation would involve the patient coming

to the provider directly. It would not involve a salesperson, even if they hold

a title like RTS, who stands to gain the sale of a several thousand dollar

wheelchair, bringing the referrals to a therapy provider.

Jimmie

*** NOTICE--The attached communication contains privileged and confidential

information. If you are not the intended recipient, DO NOT read, copy, or

disseminate this communication. Non-intended recipients are hereby placed on

notice that any unauthorized disclosure, duplication, distribution, or taking of

any action in reliance on the contents of these materials is expressly

prohibited. If you have received this communication in error, please delete

this information in its entirety and contact the Amedisys Privacy Hotline at

1-. Also, please immediately notify the sender via e-mail that you

have received this communication in error. ***

[Guest guest]

,

Let me get this straight, you don't feel that a referral from a salesperson is a

conflict of interest? I can understand your argument regarding the elimination

of the need for a referral, but that situation would involve the patient coming

to the provider directly. It would not involve a salesperson, even if they hold

a title like RTS, who stands to gain the sale of a several thousand dollar

wheelchair, bringing the referrals to a therapy provider.

Jimmie

*** NOTICE--The attached communication contains privileged and confidential

information. If you are not the intended recipient, DO NOT read, copy, or

disseminate this communication. Non-intended recipients are hereby placed on

notice that any unauthorized disclosure, duplication, distribution, or taking of

any action in reliance on the contents of these materials is expressly

prohibited. If you have received this communication in error, please delete

this information in its entirety and contact the Amedisys Privacy Hotline at

1-. Also, please immediately notify the sender via e-mail that you

have received this communication in error. ***

[Guest guest]

,

Let me get this straight, you don't feel that a referral from a salesperson is a

conflict of interest? I can understand your argument regarding the elimination

of the need for a referral, but that situation would involve the patient coming

to the provider directly. It would not involve a salesperson, even if they hold

a title like RTS, who stands to gain the sale of a several thousand dollar

wheelchair, bringing the referrals to a therapy provider.

Jimmie

*** NOTICE--The attached communication contains privileged and confidential

information. If you are not the intended recipient, DO NOT read, copy, or

disseminate this communication. Non-intended recipients are hereby placed on

notice that any unauthorized disclosure, duplication, distribution, or taking of

any action in reliance on the contents of these materials is expressly

prohibited. If you have received this communication in error, please delete

this information in its entirety and contact the Amedisys Privacy Hotline at

1-. Also, please immediately notify the sender via e-mail that you

have received this communication in error. ***

[Guest guest]

From the FEDERAL ANTI-KICKBACK LAW AND REGULATORY SAFE HARBORS:

" anyone who knowingly and willfully receives or pays anything of value to

influence the referral of federal health care program business, including

Medicare and Medicaid, can be held accountable for a felony. Violations of the

law are punishable by up to five years in prison, criminal fines up to $25,000,

administrative civil money penalties up to $50,000, and exclusion from

participation in federal health care programs. "

The referral from the DME is something of value. This is coming from and age

where companies marketing with health screenings at local health fairs are being

looked at as potential violators.

I'm not saying it is right, just that it is a concern.

Jimmie

*** NOTICE--The attached communication contains privileged and confidential

information. If you are not the intended recipient, DO NOT read, copy, or

disseminate this communication. Non-intended recipients are hereby placed on

notice that any unauthorized disclosure, duplication, distribution, or taking of

any action in reliance on the contents of these materials is expressly

prohibited. If you have received this communication in error, please delete

this information in its entirety and contact the Amedisys Privacy Hotline at

1-. Also, please immediately notify the sender via e-mail that you

have received this communication in error. ***