The Centers for Medicare & Medicaid Services (CMS) second biannual 2024 HCPCS public meeting on Nov. 6 will include discussion on a range of durable medical equipment for which manufacturers, organizations and other stakeholders are requesting new HCPCS codes or revisions to existing codes.
The best-known and most-discussed equipment item on the agenda is Complex Rehab Technology (CRT) power seat elevation, which has been a talking point all year. Seat elevation’s appearance in this latest meeting agenda is related to an allowable that stakeholders say will restrict consumer access to the technology.
But also scheduled for discussion on Nov. 6 are the following:
— S3 Uplifter Toilet Chair: CMS is being asked to establish a new HCPCS code defined as “Sit-to-stand feature with weight-activated hydraulic dual-control lever system.” Meeting notes added, “The Secure Sit to Stand patented technology has been incorporated into a toilet/showering chair to assist the individual with sitting and standing while toileting or showering. The S3 Uplifter Toilet Chair operates by a two-way hydraulic dual-lever system and weight-activated arm paddles to allow one to sit down with appropriate resistance and stand with hydraulic lever assisted lift mechanism. This feature allows the individual to softly descend when sitting and stand up with safety and support, decreasing the likelihood of a fall.”
— IndeeLift: CMS is being asked to establish a new HCPCS code: “Multipositional patient transfer system, with integrated lift, patient-accessible controls, transfer and/or lift in a seated position from floor to sit or to stand, less than 400 lbs. [weight capacity].”
— munevo DRIVE: The manufacturer has asked for a new HCPCS code: “Power wheelchair accessory, wearable smart glass based, integrated sensors, proportional, specialty control interface.” Meeting notes added, “The munevo DRIVE uses integrated sensors to calibrate head gestures which allow an individual who uses a wheelchair to navigate their power wheelchair. The device is intended for individuals who cannot use a joystick, but are able to slightly tilt and turn their head (5 degrees).”
— Wheelchair mounting hardware: Palmetto GBA has asked CMS to establish three new codes and to revise the existing E1028 code — “Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory.”
Palmetto has suggested the four codes be written as follows:
E1028: Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other.
EXXX1: Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with remote joysticks or touchpads.
EXXX2: Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type.
EXXX3: Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type.
In its meeting notes, CMS noted that a wheelchair user “will often need multiple accessories to be mounted, and this will require multiple billings of E1028, each needing a narrative description to identify the type of accessory being mounted. … Creation of the new codes will help with multiple billings of E1028, and the need to review the narrative description, manual tracking of the rental months, and correction when MUE [Medically Unlikely Edit] edits are applied.
“We believe there is a claims processing need on behalf of Medicare to address issues related to multiple billings of existing HCPCS Level II code E1028, such as review the narrative description, manual tracking of the rental months, and correction of inappropriate MUE edits.”
— Wheelchair transit accessories: Palmetto GBA has also asked CMS to establish two HCPCS codes to identify wheelchair transit accessories. “Currently, transportation tie down straps and wheelchair restraint systems are billed under existing HCPCS Level II code K0108, ‘Wheelchair component or accessory, not otherwise specified,’” the meeting notes said. “Hundreds of claim lines are billed to Medicare each quarter, which require manual adjudication. For Medicare, these items are statutorily excluded and always denied. Defined codes would automate the process,” the meeting notes said.
— Rollz Motion walker: The manufacturer has requested a new HCPCS code defined as “Walker, transport chair, folding, wheeled, adjustable or fixed height, convertible from walker to wheelchair and back.” The device is described as “a rollator and wheelchair combination. It has four large wheels, is heavy duty, foldable, has adjustable handlebars and a solid seat.”
Read the full Nov. 6 meeting notes, and attend the Nov. 6 Zoom meeting starting at 9 a.m. Eastern.
