Effective October 22, 2008, the PDAC changed the HCPCS code for the TiLite Aero Z to K0005. Suppliers should not use the K0009 or E1229 when billing the Aero Z after that date. The PDAC has already updated the DMECS database on the PDAC website to reflect this coding change.
This coding change will make it easier for Medicare beneficiaries to obtain the TiLite Aero Z. If the wheelchair user is a Medicare beneficiary who qualifies for a K0005 wheelchair, the supplier may submit the K0005 wheelchair claim to Medicare without the need to utilize the “free upgrade” procedure. Since many providers were unfamiliar or uncomfortable with the “free upgrade” procedure, this should make billing the Aero Z to Medicare easier and more straightforward.
This coding change will also make it easier for Medicaid beneficiaries to obtain an Aero Z. Many state Medicaid programs do not allow for “free upgrades.” Because of the K0005 code change, suppliers may now submit the Aero Z to those state Medicaid programs that did not permit free upgrades.
Many other state Medicaid programs have lower reimbursement levels for K0009 chairs than K0005 chairs. Due to the K0005 code change, suppliers in those states may now provide their clients with a high-quality TiLite Aero Z and achieve a better level of reimbursement. This too is a win-win for suppliers and end users.
This coding change will make it easier for end users with private insurance to obtain an Aero Z. Many private insurers do not cover K0009 products or establish unreasonably low reimbursement levels for K0009 products.
As a result of this coding change, the TiLite Aero Z now has the same HCPCS code as competing products by other manufacturers. With both competitive pricing and consistent reimbursement using the K0005 code, the TiLite Aero Z is now far more accessible to end users throughout the U.S. If you have any questions or concerns regarding this coding change or any other funding issues involving TiLite chairs, please contact Richard Forman at 800-545-2266, ext. 238 or email rforman@tilite.com. |
