DME billing can be a complicated and time-consuming process, especially when dealing with Medicare. At Atlantic Healthcare Products, we have the experience and knowledge to handle all aspects of DME billing, from working with patients and doctors to make sure that Medicare's coverage criteria is met, to filing the necessary paperwork. We are also a power wheelchair provider in Palm Beach County and can help with mobility needs. Power wheelchairs can greatly improve the quality of life for seniors or those with disabilities, and we are dedicated to making sure that our customers get the products and services they need. Contact us today to learn more about our DME billing services or to find out how we can help you with your power wheelchair needs.
The checklist below is derived from Medicare’s Coverage criteria for a Power Wheelchair. Without the below criteria being fully and legible documented in the physician's chart notes and Rx, Medical justification has not been met.
Power Wheelchair Documentation Requirements for Medicare
Checklist for Face-to-Face Examination Chart Notes for a Power Wheelchair
Do the Medical records relevant to mobility needs 1) indicate and 2) support:
▢ Reason: ‘Mobility evaluation for a Power Wheelchair’ or Powered Mobility Device –PMD
▢ Any other reason, or “follow-up” is not acceptable
▢ History of present condition and relevant past medical history:
▢ Symptoms that limit ambulation
▢ Diagnoses that are responsible for symptoms
▢ Medications or other treatment for symptoms
▢ Progression of ambulation difficulty over time
▢ Distance beneficiary can walk without stopping
▢ Pace of ambulation
▢ History of falls, including frequency, circumstances leading to falls
▢ Physical examination relevant to mobility needs:
▢ Height and weight
▢ Cardiopulmonary examination
▢ Arm and leg strength tests and range of motion tests.
▢ Neurological examination:
▢ Balance and coordination
▢ PWC Assessment:
▢ Description of the mobility limitations and how it impairs his/her ability to participate in one or more mobility-related activities of daily living (MRADLs) such as toileting, feeding, dressing, grooming, and bathing in customary locations in the home.
- AND -
prevents the beneficiary from accomplishing an MRADL entirely; - or - places beneficiary at a reasonably determined risk secondary to the attempts to perform an MRADL; - or – prevents beneficiary from completing an MRADL within a reasonable amount of time
▢ Beneficiary’s mobility limitation cannot be sufficiently and safely resolved by use of appropriately fitted cane or walker;
- AND -
▢ Beneficiary does not have sufficient upper extremity function to self-propel an optimally configured manual wheelchair in the home
- AND -
▢ Limitations of strength, endurance, range of motion, or coordination, presence of pain, or deformity or absence of one or both upper extremities;
- AND -
▢ Beneficiary does not meet coverage criteria for a Scooter or POV
▢ Beneficiary’s mental capabilities (e.g., cognition, judgment) and physical capabilities (e.g., vision) are sufficient for safe mobility; -- Beneficiary’s weight is less than or equal to weight capacity of wheelchair provided;
- AND -
▢ Beneficiary’s home provides adequate access;
- AND -
▢ Use of a power wheelchair will significantly improve the beneficiary's ability to participate in MRADLs and beneficiary will use it in the home.;
- AND -
▢ Beneficiary has not expressed an unwillingness to use a PWC in the home.
▢ 7 Element Order -
▢ beneficiary's name,
▢ item of DME ordered “Power Wheelchair”, “PWC”, or Power Mobility Device
▢ Length of Need.
▢ Date of the Face to Face Examination
▢ Date of the order
▢ Diagnosis or Dx Code
▢ Legible Signature of the ordering practitioner, or signed over printed name.
▢ Statutory Timing Requirements
▢ Did the Supplier Receive within 45 days the 7 Element Order.
▢ Did the Supplier Receive within 45 days the F2F Examination Report.
▢ Will Delivery of the Power Wheelchair be before 120 days after the F2F
Please fax your referrals and documentation to 561-290-1434
We have power wheelchairs available to purchase or rent. We have a Power Wheelchairs for Purchase, look online or visit one of our locations. If you are not ready to purchase, not sure if this is the right medical equipment for you, or just need it for a short period of time, we also have Power Wheelchair Rentals available.
Atlantic Healthcare Products is happy to offer Medicare billing for power wheelchair services. We are experienced in DME and have a long history of providing mobility equipment to those in need. Palm Beach County is a beautiful place to live, and we want everyone to be able to enjoy it to the fullest. That's why we work with patients, doctors and Medicare to make sure that coverage criteria is met and that everyone who needs a power wheelchair can get one. Contact us today to learn more about our services. We can be reached by chat, phone or just visit us at one of locations.
West Palm Beach: 561-964-6767
Boynton Beach: 561-733-2331
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