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Power Operated Vehicles (POVs)
Medicare Coverage Criteria
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A power Operated Vehicles is covered when all of the following criteria are met:
The patient's condition is such that a wheelchair is required for the patient to get around in the home,
the patient is unable to operate a manual wheelchair,
the patient is capable of safely operating the controls for the POV, and
the patient can transfer safely in and out of the POV and has adequate trunk stability to be able to safely ride in the POV.
Most POVs are ordered for patients who are capable of ambulation within the home but require a power vehicle for movement outside the home, but POVs will be denied a not medically necessary in these circumstances.
A POV that is beneficial primarily in allowing the patient to perform leisure or recreational activities will be denied as not medically necessary.
If a POV is covered, a wheelchair provided at the same time or subsequently will usually be denied as not medically necessary.
A POV is usually covered only if it is ordered by a physician who is one of the following specialties: Physical Medicine, Orthopedic Surgery, Neurology or Rheumatology.
Required Documentation: Prior Authorization, CMN, Order Prior to Delivery
This item may receive prior authorization. A CMN must be filled out, signed and dated by the ordering physician and kept on file by the physician and / or the supplier. |
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