Article - Power Mobility Devices - Policy Article (A52498)

For Very Heavy Duty, seat width and/or depth greater than 24 inches;For Extra Heavy Duty, no separate billingAny back width. Exception: For Group 3 and 4 PWCs with a sling/solid seat/back, the following may be billed separately:For Standard Duty, seat back width greater than 20 inches;For Heavy Duty, back width greater than 22 inches;For Very Heavy Duty, back width greater than 24 inches;For Extra Heavy Duty, no separate billingController and Input DeviceThere is no separate billing/payment if a non-expandable controller and a standard proportional joystick (integrated or remote) is provided. An expandable controller, a nonstandard joystick (i.e., nonproportional or mini, compact or short throw proportional), or other alternative control device may be billed separately.Refer to the bundling table in the Wheelchair Options/Accessories Policy Article for a list of codes that are not separately billable at the time of initial issue of a PWC.POV Basic Equipment Package - Each POV is to include all these items on initial issue (i.e., no separate billing/payment at the time of initial issue):Battery or batteries required for operationBattery charger, single modeWeight appropriate upholstery and seating systemTiller steeringNon-expandable controller with proportional response to inputComplete set of tiresAll accessories needed for safe operationCross Brace Chair - A type of construction for a power wheelchair in which opposing rigid braces hinge on pivot points to allow the device to fold.Power Options - Tilt, recline, elevating legrests, seat elevators, or standing systems that may be added to a PWC to accommodate a beneficiarys specific need for seating assistance.No Power Options  A category of PWCs that is incapable of accommodating a power tilt, recline, or standing system. If a PWC can only accept power elevating legrests and/or seat elevation, it is considered to be a No Power Option chair.Single Power Option - A category of PWCs with the capability to accept and operate a power tilt or power recline or power standing or, for Groups 3, 4, and 5, a power seat elevation system, but not a combination power tilt and recline seating system. It may be able to accommodate power elevating legrests, seat elevator, and/or standing system in combination with a power tilt or power recline. A PMD does not have to be able to accommodate all features to qualify for this code. For example, a power wheelchair that can only accommodate a power tilt could qualify for this code.Multiple Power Options - A category of PWCs with the capability to accept and operate a combination power tilt and recline seating system. It may also be able to accommodate power elevating legrests, a power seat elevator, and/or a power standing system. A PWC does not have to accommodate all features to qualify for this code.Actuator  A motor that operates a specific function of a power seating system  i.e., tilt, back recline, power sliding back, elevating legrest(s), seat elevation, or standing.Proportional Control Input Device - A device that transforms a user's drive command (a physical action initiated by the wheelchair user) into a corresponding and comparative movement, both in direction and in speed, of the wheelchair. The input device shall be considered proportional if it allows for both a non-discrete directional command and a non-discrete speed command from a single drive command movement. (Note: In the Wheelchair Options/Accessories policy, the term interface is used instead of control input device.)Non-Proportional Control Input Device - A device that transforms a user's discrete drive command (a physical action initiated by the wheelchair user, such as activation of a switch) into perceptually discrete changes in the wheelchair's speed, direction, or both.Alternative Control Device - A device that transforms a users drive commands by physical actions initiated by the user to input control directions to a power wheelchair that replaces a standard proportional joystick. Includes mini-proportional, compact, or short throw joysticks, head arrays, sip and puff and other types of different input control devices.Non-Expandable Controller - An electronic system that controls the speed and direction of the power wheelchair drive mechanism. Only a standard proportional joystick (used for hand or chin control) can be used as the input device. This system may be in the form of an integral controller or a remotely placed controller. The non-expandable controller:May have the ability to control up to 2 power seating actuators through the drive control (for example, seat elevator and single actuator power elevating legrests). (Note: Control of the power seating actuators though the Control Input Device would require the use of an additional component, E2310 or E2311.)May allow for the incorporation of an attendant control.Expandable Controller - An electronic system that is capable of accommodating one or more of the following additional functions:Proportional input devices (e.g., mini, compact, or short throw joysticks, touchpads, chin control, head control, etc.) other than a standard proportional joystick.Non-proportional input devices (e.g., sip and puff, head array, etc.)Operate 3 or more powered seating actuators through the drive control. (Note: Control of the power seating actuators though the Control Input Device would require the use of an additional component, E2310 or E2311.)An expandable controller may also be able to operate one or more of the following:A separate display (i.e., for alternate control devices)Other electronic devices (e.g., control of an augmentative speech device or computer through the chairs drive control)An attendant controlIntegral Control System - Non-expandable wheelchair control system where the joystick is housed in the same box as the controller. The entire unit is located and mounted near the hand of the user. A direct electrical connection is made from the Integral Control box to the motors and batteries through a high power wire harness.Remotely Placed Controller - Non-expandable or expandable wheelchair control system where the joystick (or alternative control device) and the controller box are housed in separate locations. The joystick (or alternative control device) is connected to the controller through a low power wire harness. The separate controller connects directly to the motors and batteries through a high power wire harness.Codes E2310 and E2311 describe electronic components that allow the patient to control two or more of the following motors from a single interface, e.g., proportional joystick, touchpad, or nonproportional interface:Power tiltPower recline, with or without shear reductionCombination power tilt and recline, with or without shear reductionPower leg elevation with or without articulation, power center mount elevating foot platform with or without articulating properties.The interface includes a function selection switch that allows the patient to select the motor that is being controlled and an indicator feature to visually show which function has been selected. When the wheelchair drive function has been selected, the indicator feature may also show the direction that has been selected (forward, reverse, left, right). This indicator feature may be in a separate display box or may be integrated into the wheelchair interface. Payment for the interface code includes an allowance for fixed mounting hardware for the control box and the display box, if present.A harness (E2313) describes all the wires, fuse boxes, fuses, circuits, switches, etc. that are required for the operation of an expandable controller (E2377). It also includes all the necessary fasteners, connectors, and mounting hardware.Sling Seat/Back - Flexible cloth, vinyl, leather or equal material designed to serve as the support for buttocks or back of the user respectively. They may or may not have thin padding but are not intended to provide cushioning or positioning for the user.Solid Seat/Back - Rigid metal or plastic material usually covered with cloth, vinyl, leather or equal material, with or without some padding material designed to serve as the support for the buttocks or back of the user respectively. They may or may not have thin padding but are not intended to provide cushioning or positioning for the user. PWCs with an automotive-style back and a solid seat pan are considered as a solid seat/back system, not a captains chair.Captains chair - A one or two-piece automotive-style seat with rigid frame, cushioning material in both seat and back sections, covered in cloth, vinyl, leather or equal as upholstery, and designed to serve as a complete seating, support, and cushioning system for the user. It may have armrests that can be fixed, swingaway, or detachable. It may or may not have a headrest, either integrated or separate.Stadium Style Seat - A one or two piece stadium-style seat with rigid frame and cushioning material in both seat and back sections, covered in cloth, vinyl, leather or equal as upholstery, and designed to serve as a complete seating, support, and cushioning system for the user. It may have armrests that can be fixed, swingaway, or detachable. It will not have a headrest. Chairs with stadium style seats are billed using the captains chair codes.Highway Use - Mobility devices that are powered and configured to operate legally on public streets.Push-rim activated power assist (E0986)  An option for a manual wheelchair in which sensors in specially designed wheels determines the force that is exerted by the beneficiary upon the wheel. Additional propulsive and/or braking force is then provided by motors in each wheel. E0986 is all-inclusive. All components, e.g., drive wheels, batteries, chargers, controls, mounting hardware, etc, for a manual wheel chair conversion are considered as included in 1 UOS of the code.CODE-SPECIFIC REQUIREMENTS:There are five PWC Groups and two POV Groups. Groups are divided based on performance. Each group of PMDs has subdivisions based on beneficiary weight capacity, seat type, portability, and/or power seating system capability.All POVs (K0800, K0801, K0802, K0806, K0807,K0808, K0812) must have the specified components and meet the following requirements:Have all components in the POV Basic Equipment PackageSeat Width: Any width appropriate to weight groupSeat Depth: Any depth appropriate to weight groupSeat Height: Any height (adjustment requirements-none)Back Height: Any height (minimum back height requirement-none)Seat to Back Angle: Fixed or adjustable (adjustment requirements  none)Meet the following testing requirements:Fatigue test  200, 000 cyclesDrop test  6,666 cyclesGroup 1 POVs (K0800, K0801,K0802) must meet the following requirements:Length - less than or equal to 48 inchesWidth - less than or equal to 28 inchesMinimum Top End Speed - 3 MPHMinimum Range - 5 milesMinimum Obstacle Climb - 20 mmRadius Pivot Turn - less than or equal to 54 inchesDynamic Stability Incline - 6 degreesGroup 2 POVs (K0806, K0807,K0808) must meet the following requirements:Length - less than or equal to 48 inchesWidth - less than or equal to 28 inchesMinimum Top End Speed - 4 MPHMinimum Range - 10 milesMinimum Obstacle Climb - 50 mmRadius Pivot Turn - less than or equal to 54 inchesDynamic Stability Incline - 7.5 degreesThe following requirements describe the configurations of power wheelchairs as they are coded by the Pricing, Data Analysis, and Coding (PDAC) contractor. Items provided to the beneficiary may include upgraded components which are substituted for the basic component and are billed separately. One example is a power seating system. When this is provided, the base code used should be that with a sling/solid seat/back. Another example is the provision of an expandable controller when the base code includes a non-expandable controller but is capable of an upgrade.All PWCs (K0813, K0814, K0815, K0816, K0820, K0821, K0822, K0823, K0824, K0825, K0826, K0827, K0828, K0829, K0830, K0831, K0835, K0836, K0837, K0838, K0839, K0840, K0841, K0842, K0843, K0848, K0849, K0850, K0851, K0852, K0853, K0854, K0855, K0856, K0857, K0858, K0859, K0860, K0861, K0862, K0863, K0864, K0868, K0869, K0870, K0871, K0877, K0878, K0879, K0880, K0884, K0885, K0886, K0890,K0891, K0898) must have the specified components and meet the following requirements:Have all components in the PWC Basic Equipment PackageHave the seat option listed in the code descriptorSeat Width: Any width appropriate to weight groupSeat Depth: Any depth appropriate to weight groupSeat Height: Any height (adjustment requirements-none)Back Height: Any height (minimum back height requirement-none)Seat to Back Angle: Fixed or adjustable (adjustment requirements  none)May include semi-reclining backMeet the following testing requirements:Fatigue test  200, 000 cyclesDrop test  6,666 cyclesAll Group 1 PWCs (K0813, K0814, K0815,K0816) must have the specified components and meet the following requirements:Standard integrated or remote proportional joystickNon-expandable controllerIncapable of upgrade to expandable controller