Adjustment is the name of the game in today's mobility market-particularly when it comes to Medicare walker reimbursement codes. Since a revision in 1998 altered the definition of the walker, only one product now qualifies for coverage. That has forced many walker manufacturers to reevaluate their products, their providers and their market, they say.

According to Pearl Goldstein, vice president of Brooklyn, N.Y.-based Wenzelite, the walker code change has knocked several walker manufacturers out of this Medicare business. The once-expanding walker market has taken a downturn, she says. "The codes now cover only one product, which makes it impossible for manufacturers to sell to dealers who in turn will sell to the patient at the current reimbursement."

The product that made it through the Medicare reimbursement lines is the Buddy Safety Roller, manufactured by White Cap Enterprises, Hull, Mass., whose specially designed braking system is one of the elements that set it apart from similar devices, according to president Joe Mahoney. But his product is not a walker, he says. It is designed not for people who have had hip replacements but for those with severe neurological disorders. "It is truly a therapeutic rehabilitation ambulation aid. We created the category called 'safety roller.'"

The change in coding has prompted some manufacturers to alter their products in order for them to be reimbursable, says Goldstein, adding that Wenzelite is one of them. "We would like to try to modify our prototype to get it approved by Medicare," she says. "We want to make changes and increase our market so that we will not be so affected by this ruling."

But the 1998 code change doesn't mean there's no market for walkers. "We went through 1999 without a code-believing that they would eventually kill the code," says Mike Hoepner, president of Essential Medical, Winter Park, Fla. "But our sales last year were higher than anticipated."

Following is a selection of mobility products.