Wheelchair Options/Accessories
L33792
Wheelchair options and accessories are covered only when they fall within a Medicare benefit category, are reasonable and necessary, and meet applicable Medicare requirements and documentation rules. Specific coverage criteria are defined per accessory (e.g., adjustable arm heights require >2 hours/day use and need for different arm height; elevating legrests require impaired knee flexion, edema, or reclining back; power seating requires Power Mobility Devices LCD criteria plus a specialty evaluation and ATP involvement), and claims lacking required SWO/WOPD, POD, coding compliance, or supporting specialty evaluations will be denied.
"Items are covered only if they are in a defined Medicare benefit category, are reasonable and necessary for diagnosis/treatment or to improve function of a malformed body member, and meet all other..."
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