What You Need to Know About PMD Documentation

The power mobility device industry certainly has had its share of changes and challenges over the last few years, with the elimination of the certificate of medical necessity and the advent of new codes, new coverage policy and new fee schedules.

These changes have made all involved parties adjust the way that they operate their businesses, from the PMD provider supplying the product to the ordering physician documenting the need.

While these changes have forced everyone to adapt, they have not diminished the fact that demand for PMDs will continue to grow as the baby boomer generation reaches Medicare age. Those providers that adapt the best will be well-positioned for the increased demand in the not-so-distant future.

The final rule relating to documentation for power wheelchairs and power-operated vehicles (POVs, or scooters) was published in the Federal Register back on April 5, 2006, and has been effective for claims with dates of service since June 5 of that year.

The final rule requires that the physician's order for a power mobility device and a copy of the report of the face-to-face evaluation of a patient's mobility be received by the supplier within 45 days of the completion of the face-to-face evaluation. The report of the face-to-face examination must provide information relating to the following questions in the chart/progress notes:

• What is this patient's mobility limitation and how does it interfere with the performance of activities of daily living?

• Why can't a cane or walker meet this patient's mobility needs in the home?

• Why can't a manual wheelchair meet this patient's mobility needs in the home?

• If a PWC is provided, why can't a POV (scooter) meet this patient's mobility needs in the home?

• Does this patient have the physical and mental abilities to operate a PWC/POV safely in the home?

• Is the patient willing and motivated to use the PWC or POV?

As you know, the specific elements that are addressed will depend on the patient diagnosis and its progression, which are responsible for the mobility deficit. For example, for patients with COPD, heart failure or arthritis, the major emphasis will be on symptoms and history of the progression of their condition rather than on the physical exam.