POWERED WHEELCHAIRS  | CMN  | CMN-COVERAGE

K0010- Standard weight power wheelchair

K0011- Standard weight power wheelchair with programmable controller

K0012- Lightweight portable powered wheelchair

K0013- Custom motorized/power wheelchair base

K0014- Other/ Custom Powered wheelchair base.

This chair is covered only if the feature needed is not available as an option in an already manufactured base.

COVERAGE AND PAYMENT RULES:

The patient's condition is such that without the use of a wheelchair, the patient would otherwise be bed or chair confined.

The patient's condition is such that a wheelchair is medically necessary and the patient is unable to operate a wheelchair manual K1-K5, and cannot propel in a one-arm drive manual wheelchair.

The patient is capable of safely operating the controls for the powered wheelchair.

A patient who requires a powered wheelchair usually is totally non-ambulatory and has severe weakness of the upper extremities due to a neurological or muscular condition.

A powered wheelchair is covered if the patient's condition is such that the requirement for a powered wheelchair is long term (at least six months).

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