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Appendix C: Medicare Data
Pages 463-472

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From page 463... ... No other inclusion/exclusion criterion were used for deriving the study sample cohort. Data Sources and Characteristics For this study, we used data from two data files that are part of the Medicare claims data resources. Read the entire page →
From page 464... ... • he DME claims file comprised individual-level T information such as sociodemographic characteristics and diagnosis codes. Master Beneficiary 2013–2014 The MBSF comprised individual-level characteristics such Summary File as age, gender, race/ethnicity, disability status, Medicare/ (MBSF) Read the entire page →
From page 465... ... Using that method, we could classify ICD-9 codes associated with provision of WSMDs, SGDs, and UEPs into such categories as diseases of the nervous system, diseases of the circulatory system, and diseases of the musculoskeletal system and connective tissue, among others. Table C-6 provides a full list of the ICD-9 codes and their TABLE C-2 Berenson-Eggers Type of Service Codes: Durable Medical Equipment Code Service D1A Medical/surgical supplies D1B Hospital beds D1C Oxygen and supplies D1D Wheelchairs D1E Other Durable Medical Equipment D1F Prosthetic/orthotic devices D1G Drugs administered through Durable Medical Equipment SOURCE: ResDAC, n.d.-a. Read the entire page →
From page 466... ... wheelchair K0003 Lightweight wheelchair K0004 High-strength, lightweight wheelchair K0005 Ultralightweight wheelchair K0006 Heavy-duty wheelchair K0007 Extra-heavy-duty wheelchair K0009 Other manual wheelchair/base K0011 Standard -- weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control, and braking K0014 Other motorized/power wheelchair base K0800 Power-operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds K0801 Power-operated vehicle, group 1 heavy-duty, patient weight capacity 301 to 450 pounds K0802 Power-operated vehicle, group 1 very-heavy-duty, patient weight capacity 451 to 600 pounds K0806 Power-operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds K0807 Power-operated vehicle, group 2 heavy-duty, patient weight capacity 301 to 450 pounds continued Read the entire page →
From page 467... ... APPENDIX C 467 TABLE C-3 Continued HCPCS Code Description K0808 Power-operated vehicle, group 2 very-heavy-duty, patient weight capacity 451 to 600 pounds K0814 Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds K0815 Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds K0816 Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds K0820 Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds K0821 Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds K0822 Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds K0823 Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds K0824 Power wheelchair, group 2 heavy-duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds K0825 Power wheelchair, group 2 heavy-duty, captains chair, patient weight capacity 301 to 450 pounds K0826 Power wheelchair, group 2 very-heavy-duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds K0827 Power wheelchair, group 2 very-heavy-duty, captains chair, patient weight capacity 451 to 600 pounds K0829 Power wheelchair, group 2 extra-heavy-duty, captains chair, patient weight 601 pounds or more K0835 Power wheelchair, group 2 standard, single power option, sling/solid seat/ back, patient weight capacity up to and including 300 pounds K0837 Power wheelchair, group 2 heavy-duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds K0838 Power wheelchair, group 2 very-heavy-duty, single power option sling/ solid seat/back, patient weight capacity 451 to 600 pounds K0839 Power wheelchair, group 2 very-heavy-duty, single power option sling/ solid seat/back, patient weight capacity 451 to 600 pounds K0840 Power wheelchair, group 2 extra-heavy-duty, single power option, sling/ solid seat/back, patient weight capacity 601 pounds or more K0841 Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds K0843 Power wheelchair, group 2 heavy-duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds continued Read the entire page →
From page 468... ... 468 THE PROMISE OF ASSISTIVE TECHNOLOGY TABLE C-3 Continued HCPCS Code Description K0848 Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds K0849 Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds K0850 Power wheelchair, group 3 heavy-duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds K0851 Power wheelchair, group 3 heavy-duty, captains chair, patient weight capacity 301 to 450 pounds K0853 Power wheelchair, group 3 very-heavy-duty, captains chair, patient weight capacity 451 to 600 pounds K0854 Power wheelchair, group 3 extra-heavy-duty, sling/solid seat/back, patient weight capacity 601 pounds or more K0855 Power wheelchair, group 3 extra-heavy-duty, captains chair, patient weight capacity 601 pounds or more K0856 Power wheelchair, group 3 standard, single power option, sling/solid seat/ back, patient weight capacity up to and including 300 pounds K0857 Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds K0858 Power wheelchair, group 3 heavy-duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds K0860 Power wheelchair, group 3 very-heavy-duty, single power option, sling/ solid seat/back, patient weight capacity 451 to 600 pounds K0861 Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds K0862 Power wheelchair, group 3 heavy-duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds K0870 Power wheelchair, group 4 heavy-duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds K0877 Power wheelchair, group 4 standard, single power option, sling/solid seat/ back, patient weight capacity up to and including 300 pounds K0880 Power wheelchair, group 4 very-heavy-duty, single power option, sling/ solid seat/back, patient weight 451 to 600 pounds K0884 Power wheelchair, group 4 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds K0886 Power wheelchair, group 4 heavy-duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds SOURCE: CMS, 2016. Read the entire page →
From page 469... ... Codes for Speech-Generating Devices Speech-Generating Device HCPCS Code Speech-generating device, digitized speech, using prerecorded E2502 messages, greater than 8 minutes but less than or equal to 20 minutes recording time Speech-generating device, synthesized speech, permitting multiple E2510 methods of message formulation and device access SOURCE: ASHA, n.d. classification in these diagnosis categories, while Table C-7 lists the ICD-9 codes associated with the distribution of diagnosis categories for upperextremity amputation. Read the entire page →
From page 470... ... That sample yielded a small study sample for the SGD and UEP groups, which limited the presentation of granular information based on individual-level characteristics. In future analyses, use of a 20 percent random sample and/or more years of data is needed. Read the entire page →
From page 471... ... Despite these limitations, however, the Medicare DME files are a valuable resource in the absence of universal data developed specifically to study the prescription and utilization of assistive devices. These data represent a good resource for determining the use of these devices among older adults and individuals with disabilities. Read the entire page →
From page 472... ... n.d.-c. Health care common procedure coding system. Read the entire page →

From page 463...

... No other inclusion/exclusion criterion were used for deriving the study sample cohort. Data Sources and Characteristics For this study, we used data from two data files that are part of the Medicare claims data resources.

Read the entire page →

From page 464...

... • he DME claims file comprised individual-level T information such as sociodemographic characteristics and diagnosis codes. Master Beneficiary 2013–2014 The MBSF comprised individual-level characteristics such Summary File as age, gender, race/ethnicity, disability status, Medicare/ (MBSF)

Read the entire page →

From page 465...

... Using that method, we could classify ICD-9 codes associated with provision of WSMDs, SGDs, and UEPs into such categories as diseases of the nervous system, diseases of the circulatory system, and diseases of the musculoskeletal system and connective tissue, among others. Table C-6 provides a full list of the ICD-9 codes and their TABLE C-2 Berenson-Eggers Type of Service Codes: Durable Medical Equipment Code Service D1A Medical/surgical supplies D1B Hospital beds D1C Oxygen and supplies D1D Wheelchairs D1E Other Durable Medical Equipment D1F Prosthetic/orthotic devices D1G Drugs administered through Durable Medical Equipment SOURCE: ResDAC, n.d.-a.

Read the entire page →

From page 466...

... wheelchair K0003 Lightweight wheelchair K0004 High-strength, lightweight wheelchair K0005 Ultralightweight wheelchair K0006 Heavy-duty wheelchair K0007 Extra-heavy-duty wheelchair K0009 Other manual wheelchair/base K0011 Standard -- weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control, and braking K0014 Other motorized/power wheelchair base K0800 Power-operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds K0801 Power-operated vehicle, group 1 heavy-duty, patient weight capacity 301 to 450 pounds K0802 Power-operated vehicle, group 1 very-heavy-duty, patient weight capacity 451 to 600 pounds K0806 Power-operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds K0807 Power-operated vehicle, group 2 heavy-duty, patient weight capacity 301 to 450 pounds continued

Read the entire page →

From page 467...

... APPENDIX C 467 TABLE C-3 Continued HCPCS Code Description K0808 Power-operated vehicle, group 2 very-heavy-duty, patient weight capacity 451 to 600 pounds K0814 Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds K0815 Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds K0816 Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds K0820 Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds K0821 Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds K0822 Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds K0823 Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds K0824 Power wheelchair, group 2 heavy-duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds K0825 Power wheelchair, group 2 heavy-duty, captains chair, patient weight capacity 301 to 450 pounds K0826 Power wheelchair, group 2 very-heavy-duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds K0827 Power wheelchair, group 2 very-heavy-duty, captains chair, patient weight capacity 451 to 600 pounds K0829 Power wheelchair, group 2 extra-heavy-duty, captains chair, patient weight 601 pounds or more K0835 Power wheelchair, group 2 standard, single power option, sling/solid seat/ back, patient weight capacity up to and including 300 pounds K0837 Power wheelchair, group 2 heavy-duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds K0838 Power wheelchair, group 2 very-heavy-duty, single power option sling/ solid seat/back, patient weight capacity 451 to 600 pounds K0839 Power wheelchair, group 2 very-heavy-duty, single power option sling/ solid seat/back, patient weight capacity 451 to 600 pounds K0840 Power wheelchair, group 2 extra-heavy-duty, single power option, sling/ solid seat/back, patient weight capacity 601 pounds or more K0841 Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds K0843 Power wheelchair, group 2 heavy-duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds continued

Read the entire page →

From page 468...

... 468 THE PROMISE OF ASSISTIVE TECHNOLOGY TABLE C-3 Continued HCPCS Code Description K0848 Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds K0849 Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds K0850 Power wheelchair, group 3 heavy-duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds K0851 Power wheelchair, group 3 heavy-duty, captains chair, patient weight capacity 301 to 450 pounds K0853 Power wheelchair, group 3 very-heavy-duty, captains chair, patient weight capacity 451 to 600 pounds K0854 Power wheelchair, group 3 extra-heavy-duty, sling/solid seat/back, patient weight capacity 601 pounds or more K0855 Power wheelchair, group 3 extra-heavy-duty, captains chair, patient weight capacity 601 pounds or more K0856 Power wheelchair, group 3 standard, single power option, sling/solid seat/ back, patient weight capacity up to and including 300 pounds K0857 Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds K0858 Power wheelchair, group 3 heavy-duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds K0860 Power wheelchair, group 3 very-heavy-duty, single power option, sling/ solid seat/back, patient weight capacity 451 to 600 pounds K0861 Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds K0862 Power wheelchair, group 3 heavy-duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds K0870 Power wheelchair, group 4 heavy-duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds K0877 Power wheelchair, group 4 standard, single power option, sling/solid seat/ back, patient weight capacity up to and including 300 pounds K0880 Power wheelchair, group 4 very-heavy-duty, single power option, sling/ solid seat/back, patient weight 451 to 600 pounds K0884 Power wheelchair, group 4 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds K0886 Power wheelchair, group 4 heavy-duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds SOURCE: CMS, 2016.

Read the entire page →

From page 469...

... Codes for Speech-Generating Devices Speech-Generating Device HCPCS Code Speech-generating device, digitized speech, using prerecorded E2502 messages, greater than 8 minutes but less than or equal to 20 minutes recording time Speech-generating device, synthesized speech, permitting multiple E2510 methods of message formulation and device access SOURCE: ASHA, n.d. classification in these diagnosis categories, while Table C-7 lists the ICD-9 codes associated with the distribution of diagnosis categories for upperextremity amputation.

Read the entire page →

From page 470...

... That sample yielded a small study sample for the SGD and UEP groups, which limited the presentation of granular information based on individual-level characteristics. In future analyses, use of a 20 percent random sample and/or more years of data is needed.

Read the entire page →

From page 471...

... Despite these limitations, however, the Medicare DME files are a valuable resource in the absence of universal data developed specifically to study the prescription and utilization of assistive devices. These data represent a good resource for determining the use of these devices among older adults and individuals with disabilities.

Read the entire page →

From page 472...

... n.d.-c. Health care common procedure coding system.

Read the entire page →

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Appendix C: Medicare Data Pages 463-472

Appendix C: Medicare Data
Pages 463-472