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Lightweight wheelchairs must be billed with HCPCS code K0003 (lightweight wheelchair), K0004 (high strength, lightweight wheelchair) or K0012 (lightweight portable motorized/power wheelchair). Ultralightweight wheelchairs must be billed with HCPCS code K0005 (ultralightweight wheelchair).
The written prescription must include the beneficiary's name, the date of the face-to-face exam, the diagnoses and conditions that support the claim for the PMD, a description of the specific type of PMD required, and the expected length of time the patient will need the equipment.
Many types of orthopedic or neuromuscular impairments can impact mobility. These include but are not limited to amputation, paralysis, cerebral palsy, stroke, multiple sclerosis, muscular dystrophy, arthritis, and spinal cord injury.
CPT® Code 97535 - Physical Medicine and Rehabilitation Therapeutic Procedures - Codify by AAPC.
Cerebrovascular disease is the most common neurological condition leading to wheelchair use (25% of wheelchair users have had a stroke). And many other people with neurological disorders spend time in a wheelchair: for example, those with spinal injuries, multiple sclerosis, polio and muscular dystrophy.
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SWO & Face-to-Face Encounter Documentation You must: Get a written, signed, and dated SWO before delivering the PMD. However, if a particular PMD doesn't appear on the prior authorization list, submit the order to the supplier before claim submission. Only power wheelchairs require the written order prior to delivery.
The Mobility Evaluation Program (MEP) is part of the Department of Rehabilitation (DOR) and serves DOR clients. We determine the adaptive driving equipment, vehicle, vehicle modifications, and training a client needs to be a safe and independent driver.
The functional mobility assessment (FMA) instrument is a self-report outcomes tool designed to measure effectiveness of wheeled mobility and seating (WMS) interventions for PWD. This study examined the test-retest reliability of the FMA, and the stability of self-reported performance items.
Overview of Code 97542 Code 97542 is used to report management of a patient using a wheelchair including assessment (eg, pos- tural/positioning needs), fitting (eg, pressure relief), and training (eg, getting in and out of the wheelchair safely and managing wheelchair propulsion on various terrains).
In most cases the physical assessment will also include a full musculoskeletal examination of the users range of motion, joint flexibility, muscle length, and skeletal alignment, with neurological issues such as tone and spasm pattern also noted as they affect posture and muscle length.

wheelchair assessment form