Tag: K0856
Most read stories: Will 2018 be the year of widespread prior authorizations?
January 23, 2018Liz Beaulieu, Editor
YARMOUTH, Maine - The big story in mobility for 2017 was CMS's new prior authorization program for two complex rehab codes, K0856 and K0861.Authorize thisPrior authorizations were the subject of two of the most read stories for 2017: “CMS announces first codes up for PA process” (No. 2) and “It's a bumpy start for prior authorizations” (No. 4).Mobility providers are no strangers to prior authorizations, which CMS already requires in 19 states for standard power wheelchairs...
Prior auth update: No involvement from ATP trips some providers
April 28, 2017Liz Beaulieu, Editor
WASHINGTON - CMS gave insight into how providers are doing with a new prior authorization process for two complex rehab codes during the third in a series of Special Open Door Forums on April 25.During the forum, Dr. Robert Hoover, the chief medical officer for CGS Administrators, the DME MAC for Jurisdictions B and C, cited top non-affirmation reasons for K0856 and K0861 so far. An issue that has popped up in both jurisdictions: no evidence that an ATP had direct, in-person involvement in the selection...
It's a bumpy start for prior authorizations
March 10, 2017Liz Beaulieu, Editor
WASHINGTON - CGS and Noridian have begun accepting prior authorization requests for K0856 and K0861, but complex rehab providers say they still don't have all the information they need to comply with the program.The contractors on March 6 began accepting requests for dates of delivery on or after March 20.“We're as prepared as we can be, with all the unanswered questions,” said Doug Westerdahl, president and CEO of Rochester, N.Y.-based Monroe Wheelchair, who, because of the uncertainty,...