CMS Medicare final coding seat elevation approval

[F3Head]

CMS Issues Final Coding, Benefit Category, Payment Determinations for Seat Elevation
New coding will go into effect in April.

March 1, 2024 by Laurie Watanabe

The Centers for Medicare & Medicaid Services (CMS) has issued its final coding, benefit category, and payment determinations for seat elevation on power wheelchairs.
The determinations were included as part of CMS’s Second Biannual 2023 HCPCS Coding Cycle. CMS said new coding actions would be effective starting April 1, 2024, unless otherwise noted.

https://mobilitymgmt.com/cms-issues-fin ... ign=109450

F3HEAD For what it's worth

[Burgerman]

Centers for Medicare & Medicaid Services (CMS) has issued its final coding, benefit category, and payment determinations for seat elevation on power wheelchairs.
The determinations were included as part of CMS’s Second Biannual 2023 HCPCS Coding Cycle. CMS said new coding actions would be effective starting April 1, 2024, unless otherwise noted.

Not sure what any of that stuff means?

But I recently was assessed for a chair by the UK wheelchair services. They approve anything that you have legitimate clinical need for. So regarding seat elevator I just explained that I needed to reach the bar at a sensible height to be served! No thats a lie. But was funny. I did mention it though.

I exlained that I needed to be high enough to empty a leg bag into a toilet, to transfer to various surfaces, to reach all the plastic containers on the high shelves in my room, to wash my van, to do photography, to get to the high cupboards in my kitchen so I can eat. Any one of those things is needed for your social lifestyle and holistic needs and acceptable if you live alone or need that usage.

Same with tilt, recline, power centre footrest, and I explained that less than 4 pole and 120A and R-Net wouldnt cut it... They added those to the list too. Basically if you can explain using sensible understandable logic, then thats enough.

[Burgerman]

Can you not get seat lift if you need it already?

[daveonwheels]

i paid $1500 for mine in 2019. its long been considered not medically necessary

[Burgerman]

How can they expect you to empty a leg bag into the toilet? Or levitate up to transfr to higher surfaces? That is medically neccassary? Or reach things higher up so you can use a kitchen or whatever. If it limits independence then it actually costs more while limiting your life. Joined up thinking needed here...

I have always had a lift chair around even if not needed all the time. They make a chair worse in many ways. So if I dont need it that day I use some other chair. Say to drive from. But the odd times when you need it you just do!

Once everyone can get one they will see that as a good thing. Everyone will tick the box. Watch all the error codes, breakdowns from inhibit problems and mostly the huge number of posts complaining about batteries dying and range issues and blamng batteries made in china etc... in the future... Because weight (huge difference), added complexity of inhibits and wiring getting stretched up and down etc etc...

One thing well worth doing if you have lif is to move seating to all extremes and carefully watch the wiring to be sure nothing gets pulled tight or trapped. They dont seem to take much care when routing and fixing cables.

[slomobile]

Joined up thinking needed here...

I've heard that phrase here before but don't understand what it means.
I've heard Brits are champions of the que (Hitchhikers Guide to the Galaxy). Is it somehow related to that?

[Burgerman]

No. It just means that in THIS CASE the fact that the wheelchair lift helps you be more independant and that this means that YOU get a better. outcome and the same socialist ststem that provides care and help would be cheaper since you can do stuff yourself.

Joned up = different departments of the government (in this case) would save money with a seat lift being provided. Same way as tilt/recline/power legs means less pressure sore issues. Again less medical care required (gov saves NHS money) and better outcome for you. Joined up instead of 3 seperate government departments all trying to save money.

Another e.g. They finally figured out that its cheaper for nurses, hospital care, carers, etc if they give all the carers and vulnerable and old "free" flue vaccines. Because the alternative costs them more in the end.

[martin007]

For bureaucrats it is a great effort to get out of the manual of instructions.
They don't understand life outside of their system.

[Burgerman]

Yes they all live in individual disconnected boxed! But here in he UK they are BEGINNING to get it. And must consider not only clinical needs but holistic lifestyle (joined up) needs. They dont like it. But are now forced to consider these things.

[slomobile]

I get it. Reminds me of a hockey reference from one of my favorite shows from Canukistan

"Remember, we're all in this together. Keep your stick on the ice." -Red Green

The Red Green show https://redgreen.com/