Standardized Repair and Service Guide

2

Introduction

U.S. Rehab is the nation’s largest network of independently owned rehab technology providers.

The VGM Group, Inc., company has more than

360 members in more than 1,100 locations throughout the U.S.

Members whose service technicians have been trained and tested by U.S. Rehab vendors make up the Red, White & Blue Certified Repair Network.

The certifications ensure that patients and payer sources receive the best service available for their mobility equipment needs.

As technology evolves, servicing and repairing rehab equipment becomes more challenging. Our

Standardized Rate Guide was developed so service providers have guidelines about fair and adequate compensation levels, ensuring an accurate and consistent basis for the billing and reimbursement of repair services.

Red, White, Blue Certified Repair Network

Standardized Repair and Service Guide

Table of Contents

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

How to use this guide . . . . . . . . . . . . . . . . . . . . . . . 4

Repair questionnaire . . . . . . . . . . . . . . . . . . . . . . . . 5

Standardized Labor Rate Tables:

Standard Manual Chair

Folding and Rigid Frame . . . . . . . . . . . . . . . 6-11

Scooters . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-17

Power Wheelchair

Gearbox/Direct Driven/Belt Drive . . . . . . . 18-26

KO462 Billing for loaner equipment . . . . . . . . . . . 27

Pointers on repairs . . . . . . . . . . . . . . . . . . . . . . . . 28

Updates to labor payment rates . . . . . . . . . . . . . . . 29

Repair labor billing and payment policy . . . . . . . . . 30

Payment for delivery and service charges for durable medical equipment . . . . . . . . . . . . 31-32

Repair shop pointers . . . . . . . . . . . . . . . . . . . . 33-34

Steps to easy power wheelchair maintenance . 35-36

Steps to easy manual wheelchair maintenance 37-38

Job Classification Section . . . . . . . . . . . . . . . . 39-58

U .S . Rehab Exclusive Vendors . . . . . . . . . . . . . . . . . 59

Copyright 2012 U.S. Rehab ®

Multiple uses for this guide

1. Give to service managers so they have a way to document time spent on standard

service and repairs for most manual and power wheelchairs. Tools are provided to set

up your workflow on computer.

2. Tracking repair time and processes is very helpful when discussing and negotiating

reimbursement issues with payer sources.

3. The guide considers all major brands and models, individual technologies and

combines their service recommendations into a piece that is accurate and credible.

Preface

Advancements in rehab technology have occurred rapidly, and more are coming. The Red, White & Blue Certified Technician Program was developed to provide member companies and service technicians with the education and skills necessary to work efficiently and professionally. However, education and skill are not enough to be successful in business. Billing and reimbursement are a daily concern.

This rate guide was a collaborative effort among U.S. Rehab staff, our manufacturers and service providers at U.S. Rehab Member companies. We consider it a “living document” that will be updated as necessary.

The time allowances in this guide are based on federally mandated operating criteria and take into consideration the repair center’s adherence to strict quality standards.

Repair center criteria

1. Site is fully accredited.

2. There is a certified technician on staff.

3. A continuing education program keeps staff current on job skills.

4. A fully operational service/repair shop has appropriate equipment, both

diagnostic and mechanical tools, any specialized tools, fixtures or jigs as specified

by manufacturers, and adequate floor and bench space with proper ventilation

and lighting.

5. There is a designated area to clean dirty/contaminated equipment. Refer to ACO

Quality Assurance Requirements.

6. There is ample storage for equipment staged for service.

7. An established set of policies and procedures for the safe handling and disposal

of hazardous materials (batteries, solvents, circuit boards, cleaning materials)

exists, and complies with EPA, local ordinances and respective MSDS sheets.

8. An adequate inventory of parts for standard repairs is kept.

9. Accurate and current repair and service records allow equipment to be tracked in

case of a product recall or safety update.

10. All repairs are made according to manufacturer standards. Service manuals, technical publications, parts catalogs and service bulletin are kept on file for reference.

11. If billing Medicare for complex rehab, technicians must earn required continuing education units annually.

3

4

Time Table Conversion

How to use this guide:

1. Each section is broken down by category.

2. For standardization purposes, the repair time estimates

have been converted from minutes to decimals in tenths

and quarters of an hour. This allows the service manager

to quote individual repairs in comparison or in addition

to minimum labor charges.

Minutes Decimals

6 0.10

15 ¼ Hour 0.25

30 ½ Hour 0.50

45 ¾ Hour 0.75

3. These estimated repairs do not include cleaning,

abnormal rust, corrosion or damaged equipment that

requires extra time. It is recommended that additional

time be billed for those tasks.

60 1 Hour 1.00

4. Pickup and delivery are not included in these

suggested times. Follow company billing procedure

for these services.

5. Initial troubleshooting and repair diagnostics are

included in these standard rates and times. Additional

or advanced diagnostics should be charged as

additional time.

Working with standardized rates requires certain procedures to be standard policy .

The following are true for service and repair of all mobility equipment:

Medicare doesn’t reimburse for pickup and delivery of repairable items, so you can’t bill a patient for this service. These are additional charges and are billed according to your company’s policy for other insurance carriers.

All equipment should be cleaned, disinfected, tagged and the required service documented before the piece enters the service area. It is recommended 1.0 hour be added for cleaning and disinfecting.

Custom fabrication or complex repairs are not in the standard rate tables and should be billing accordingly.

A minimum labor charge should be applied to all repairs; do not waive it because a repair is small and didn’t take much time.

The tables and forms in this guide may be copied.

See attached CD on the back of the booklet.

Repair questionnaire:

Patient Name __________________________________________________________

Medicare No. __________________________________________________________

Address _______________________________________________________________

Name, Make and Model of the item that is being repaired:

_______________________________________________________________________________

Serial number of item being repaired:

_______________________________________________________________________________

Date wheelchair (item) was provided: ____________________________________

How was wheelchair (item) funded? (payer source): ________________________

If funded by Medicare was chair (item) purchased or rented? ________________

If the wheelchair (item) was provided by a company other than _________________________ the information above must be confirmed by the supplier (if the supplier is unknown to the patient or out of business do a three way call to Medicare and get correct information.)

Confirmed by: ____________________ (employee)

Date: ____________________

You must make sure that your staff document what exactly was done and break out in increments of 15 minutes time for each item repaired/replaced i.e.- changed rt arm pad ____ minutes /replaced rt tire _____ minutes etc.

USREH-R001

5

6

Standardized Repair and Service Rate Tables:

Standard Manual Chair

–

Folding and Rigid Frame

Standardized repair table with commonly used HCPCS codes:

STANDARD MANUAL CHAIR FOLDING and RIGID FRAME REPAIR

Date Provided: ____________

Client Name:____________________________________________________________________________

Manufacturer: _________________________ Model #: ______________ Serial #: _____________

Nature of Problem: ______________________________________________________________________

Loaner Chair received:

Yes: _____ No: _____ Name: ________________ Make: _____________ Model: _______________

Serial #: ________________________

(01) Wheels, Tires, Forks

Part

Number

Billing Code

Tire and/or tube replacement, includes wheel remove/replace

Replace pneumatic tire and/or tube

(per wheel)

Replace pneumatic tire with airless insert

(per wheel)

Replace solid snap-on tire (per wheel)

E2211 tire

E2212 tube

E2211 tire

E2213 airless insert

E2220

Time # Units

Rear wheels

Replace wheel assembly (each)

Spoked wheels: true rim & replace spokes as noted:

No spokes required

1-5 spokes required (additional time)

6 or more spokes required

(additional time)

Replace quick release axle (each)

Replace threaded axle (each)

Replace and adjust bearings, per wheel

(each)

Adjust bearing play only, per wheel

Adjust camber

Replace camber sockets/brackets (pair)

Handrims (per wheel)

Replace handrim only

Replace threaded inserts

K0069 solid tire

K0070 pneumatic tire

K0108

K0108

K0108

K0108

K0108

K0108

E2210

K0739

K0739

K0108

E2205

E2205

K0108

7

8

Casters and forks

Replace caster/fork assembly (each) E2226

Replace stem bearings, adjust (per fork)

Remove stem bearings, lube and adjust

(per fork)

Replace caster wheel (each)

E2210

K0739

E2225

Replace caster wheel **, bearings, adjust

(per wheel)

**

K0071 Front caster comp pneumatic tire

K0072 Front caster comp semi-pneumatic tire

K0073 Caster pin lock each

K0077 Front caster assembly complete

E2214 Pneumatic caster tire each

E2215 Pneumatic caster tire tube

E2210

E2217 Foam filled caster tire each

E2219 Foam caster tire any size each

E2221 Solid caster tire each

E2222 Solid caster integrated wheel

E2225 Caster wheel excludes tire

E2384 Pneumatic caster tire

Wheel lock replacement and adjustment

Toggle lock (each)

Toggle locks with grade aid (each)

Lever locks (all types) (each)

Replace wheelchair brake extension


(per wheel)

Section Total

Wheel locks, adjust only

Toggle locks (both)

Toggle locks with grade aid (both)

Lever locks (all types) (both)

Replace wheelchair brake extension


(per wheel)

Section Total

Part

Number

(02) Armrests

Replace armrest latch or lock (each)

Replace armrest pad (each)

Replace armrest sidepanel, screw type

(each)

Replace armrest sidepanel, pop rivet type

(each)

Replace detach non-adjust height armrest

Replace detach adjust armrest base

E2206

K0108

E2206

E0961

E2210

E2206

K0108

E2206

E0961

E2210

Billing Code

K0108

K0019

K0108

K0108

K0015

K0017

E2385 Tube, pneumatic caster tire

E2387 Foam filled caster tire

E2391 Solid caster tire

E2392 Solid caster tire, integrate

E2395 Caster wheel excludes tire

E2396 Caster fork

Time # Units

(02) Armrests

Replace detach adjust armrest upper

Replace arm pad (each)

Replace fixed adjust armrest pair

Replace access detach adjust armrest

Replace standard wheelchair armrest

Replace wheelchair fixed full length arms

Replace wheelchair detachable arms

Section Total

Part

Number

(03) Legrests and Footrests

Replace elevating legrest assembly, nonpowered (each)

Replace adjust angle footplate (each)

Replace large size footplate (each)

Replace standard size footplate each

Replace footrest lower extension tube

Replace footrest upper hanger bracket

Replace footrest complete assembly

Replace elevate legrest low extension

Replace elevate legrest up hanger bracket

Replace swingaway detach footrest

Replace elevate footrest articulate

Replace loop heel

Replace toe loop/holder (each)

Replace wheelchair No . 2 footplates

Swinging and detachable cam or latch block device

Section Total

(04) Backs

Back upholstery

Replace standard back sling upholstery

ADD for adjustable tension sling

ADD to replace broken screw in back post (requires drilling)

Part

Number

Part

Number

Billing Code

K0018

K0019

K0020

E0973

E0994

E1050

E1060

Billing Code

E0990

K0047

K0052

K0053

E0951

E0952

E0970

K0040

K0041

K0042

K0043

K0044

K0045

K0046

K0108

Billing Code

E0982

E0982

K0108

K0108

Time

Time

Time

# Units

# Units

# Units

9

10

(04) Backs

Replace solid back insert

Back posts, manual

Non-folding, one post

Non-folding, both posts

Folding, one post

Folding, both posts

Replace push handle grips (pair)

Section Total

(05) Seats

(standard sling or basic insert)

Replace seat upholstery

Solid seat insert

Section Total

(06) Frames and

Related - Folding

Complete disassembly and assembly

Replace sideframes (single or pair)

Replace crossbars (single or pair)

Replace crossbar inner rail (per side)

Replace seat rail guide tips/slides

(per side)

Replace front post telescopic slides

(per side)

Section Total

(07) Frames and Related - Rigid

Complete disassembly and assembly

Section Total

Part

Number

Part

Number

Part

Number

Part

Number

Billing Code

E0992

K0108

K0108

K0108

K0108

K0108

K0108

Billing Code

E0981

E0992

Billing Code

K0739

K0108

K0108

K0108

K0108

K0108

Billing Code

K0739

Time

Time

Time

Time

# Units

# Units

# Units

# Units

(08) Miscellaneous and General Services

Replace all plastic/rubber parts (less tires)

Replace and glue on post grips

Complete cleaning and disinfecting per

OSHA (with no rust or corrosion)

Remove broken/stripped screw (drill and tap) add to job time

Remove broken/stripped bolt (drill and tap) add to job time

Section Total

Section 1 Total

Section 2 Total

Section 3 Total

Section 4 Total

Section 5 Total

Section 6 Total

Section 7 Total

Section 8 Total

Grand Total

Part

Number

Billing Code

K0108

K0108

K0739

K0739

K0739

Time # Units

USREH-MC001

*Billing codes are subject to change make sure updates are followed as of date published by Medicare.

11

12


Scooters and POVs


SCOOTERS and POVs


Client Name:____________________________________________________________________________





Serial #: ________________________

(01) Batteries and Cables

Replace batteries

Check and clean terminals, charge and match voltages within 0 .2 volts, clean battery boxes of dirt and electrolyte per all OSHA hazardous material handling procedures, and dispose of old batteries per EPA and local ordinances .

DOES NOT INCLUDE TESTING

Check and clean terminals, charge and match voltages within 0 .2 volts, clean battery boxes of dirt and electrolyte per all OSHA hazardous material handling procedures, and dispose of old batteries per EPA and local ordinances .

INCLUDES TESTING

Testing and diagnosis

Check for voltage at charger port .

Check for voltage at battery terminals of individual batteries and compare results .

Part

Number

Billing Code

K0739

K0739

K0739

Time # Units

13

14

Cables and connectors

Clean battery terminals only

Replace battery cable/harness

Replace tiller to controller cable

Repair/clean connectors

Replace contact(s) in connector:

Replace 1 contact

Add for each additional contact

Replace multi-pin connector assembly

Section Total

K0739

K0108

K0108

K0739

K0108

K0108

K0108

K0108

(02) Motors

Part

Number

Billing Code Time

Replace power wheelchair motor replacement only

Replace wheelchair gear box only

E2368

E2369

Replace power wheelchair motor/gear box combo

E2370

Inspection of brushes: check length, wear pattern and spring for evidence of excessive heat

1 motor K0739

Both motors

Replace brushes, inspect commutator, seat brushes:

K0739

1 motor

Both motors

Section Total

K0108

K0108

Part

Number

Time (03) Drive Train Belt/Chain

Belt tension adjustment

Chain tension adjustment

Belt replacement

Chain replacement

Section Total

Billing Code

K0739

K0739

K0108

K0108

# Units

# Units

(04) Electronics

Replace power module

(ADD programming if required):

Program power module (basic parameters)

Replace tiller components:

Replace throttle potentiometer, calibrate (includes tiller removal/replacement)

ADD: solder if required

Replace tiller board

Part

Number

Billing Code

K0108

K0739

K0108

K0108

K0739

K0108

Per item below, not to exceed .5 hour for any multiple

Replace battery meter

Replace headlight

Replace headlight switch

Replace speed potentiometer

Replace key switch

Replace 1 contact

Section Total

K0108

A9270

A9270

K0108

K0108

K0108

Part

Number

(05) Battery Chargers

Test charger output

Replace fuse

Replace on-board charger

Section Total

Billing Code

K0739

K0108

K0108

(06) Frames and Shrouds

Replace frame base

Part

Number

Billing Code

K0108

Replace tiller assembly

Quick release (no tools required)

Bolt-on tiller

K0108

K0108

Time

Time

Time

# Units

# Units

# Units

15

16

Replace shroud (each)

Tiller shroud

Base shroud

Section Total

(07) Wheels and Tires

Part

Number

Replace drive wheel assembly (each)

Replace foam filled drive wheel tire each

Replace foam drive wheel tire each

Replace drive wheel excludes tire each

Replace pneumatic drive wheel tire

Replace tube, pneumatic wheel drive tire

Replace pneumatic caster tire

K0108

K0108

Billing Code

E2386

E2388

E2394

E2381

E2382

E2383

Tires/tubes (per wheel)

Replace pneumatic tire and/or tube

Replace pneumatic tire with airless insert and split rim

Section Total

(08) Armrests



Replace armrest sidepanel, screw type (each)

Replace armrest sidepanel, pop rivet type (each)

Replace detach non-adjust height armrest

Replace detach adjust armrest base

Replace detach adjust armrest upper

Replace arm pad (each)

E2211 tire

E2212 tube

E2211 tire

E2213 airless insert

Part

Number

Billing Code

K0108

K0019

K0108

K0108

K0015

K0017

K0018

K0019

Time

Time

# Units

# Units

(08) Armrests

Replace fixed adjust armrest pair

Replace access detachable adjust armrest

Replace standard wheelchair armrest

Replace wheelchair fixed full length arms

Replace wheelchair detachable arms

Section Total

Part

Number

Billing Code

K0020

E0973

E0994

E1050

E1060

(09) Seats and Backs

Replace seat assembly, captain or van type

Replace rehab seat

Replace folding back

Section Total

Part

Number

Billing Code

K0108

K0108

K0108


Part

Number

Complete cleaning and disinfecting per OSHA

Billing Code

With no rust or corrosion

Minor rust or corrosion

Remove broken/stripped screw (drill and tap) add to job time

Remove broken/stripped bolt (drill and tap) add to job time

Section Total

K0739

K0739

K0739

K0739

Section 1 Total

Section 2 Total

Section 3 Total

Section 4 Total

Section 5 Total

Section 6 Total

Section 7 Total

Section 8 Total

Section 9 Total

Section 10 Total

Grand Total

Time

Time

Time

# Units

# Units

# Units

USREH-SC001


17

18


Power Wheelchair

–

Gearbox/Direct Driven/Belt Drive


POWERWHEELCHAIR – GEARBOX / DIRECT DRIVE / BELT DRIVE


Client Name:____________________________________________________________________________





Serial #: ________________________

Part

Number

Billing Code Time # Units (01) Batteries, Cables

Replace batteries

Check & clean terminals, charge and match voltages within 0 .2 volts, clean battery boxes of dirt and electrolyte per all OSHA hazardous material handling procedures, and dispose of old batteries per EPA and local ordinances .

DOES NOT INCLUDE TESTING

Check & clean terminals, charge and match voltages within 0 .2 volts, clean battery boxes of dirt and electrolyte per all OSHA hazardous material handling procedures, and dispose of old batteries per EPA and local ordinances .

INCLUDES TESTING

Testing and diagnosis

Check for voltage at charger port .

Check for voltage at battery terminals of individual batteries and compare results .

Load test batteries (in series)

Voltage and load test (both as above)

Test for voltage drop under load

K0739

K0739

K0739

K0739

K0739

K0739

K0739


Clean battery terminals only

Replace battery cable/harness

Replace wire harness

Replace contact(s) in connector

K0739

K0108

K0108

K0108

19

20


Replace 1 contact

ADD for each additional contact

Replace multi-pin connector assembly

Section Total

K0108

K0108

K0108

(02) Motors

Part

Number

Billing Code Time

Replace power wheelchair motor replacement only

Replace wheelchair gear box only

E2368

E2369

Replace power wheelchair motor/gear box combo

E2370


1 motor K0739

K0739 Both motors


1 motor

Both motors

K0108

K0108

2-pole motors only


1 motor

Both motors

K0739

K0739

K0739

K0739


1 motor

Both motors

K0108

K0108

4-pole motors only


1 motor

Both motors

K0739

K0739


1 motor

Both motors

K0108

K0108

# Units

Test motors for current draw (amps)

1 motor

Both motors

Section Total

Part

Number

(03) Electronics

Replace hand/head control

Electro connect btw control

Electro connect btw 2 sys

Mini-prop remote joystick

Power wheelchair harness, expand control

Hand interface joystick

Multi-mechanism switches

Special joystick handle

Chin cup interface

Sip and puff interface

Breath tube kit for sip & puff interface

Head control interface mechanism

Head/extremity control interface

Head control nonproportional

Head control proximity switch

Attendant control

K0739

K0739

Billing Code

E2324

E2325

E2326

E2327

E2328

E2329

E2330

E2331

E2310

E2311

E2312

E2313

E2321

E2322

E2323

Time # Units

Programming (basic, initial settings): **CAN BE PART LABOR CODE WHEN DOING REPAIRS

Integral power module/joystick

Power module with standard remote joystick

Power module with specialty controls

Section Total

K0739 **

K0739 **

K0739 **

21

22

(04) Battery Chargers

Test charger output

Replace fuse

Replace on-board charger

Section Total

Part

Number

(05) Frames,

Shrouds, Crossbraces

Replace frame base

Without power tilt and/or recline

With power tilt and/or recline

Replace cowling/shroud (each)

Replace sideframe, belt driven

Right or left side only

Both sides

Replace cross braces

Without power tilt and/or recline

With power tilt and/or recline

Replace crossbar inner rail (per side)

Replace seat rail guide tips/slides (per side)

Standard arm models

Detachable arm models

Replace front post telescopic slides (per slide)

Standard arm models with detachable arms

Reclining back models

Section Total

Part

Number


Part

Number

Replace drive wheel assembly (each)

Replace foam filled drive wheel tire each

Replace foam drive wheel tire each

Replace drive wheel excludes tire each

Billing Code

K0739

K0108

K0108

Billing Code

K0108

K0108

K0108

K0108

K0108

K0108

K0108

K0108

K0108

K0108

K0108

K0108

Billing Code

E2386

E2388

E2394

Time

Time

Time

# Units

# Units

# Units


Replace pneumatic drive wheel tire

Replace tube, pneumatic wheel drive tire

Replace pneumatic caster tire

Part

Number

Billing Code

E2381

E2382

E2383

Casters and forks

Replace caster fork assembly (each)

Replace stem bearings and adjust

(per fork)

Replace caster wheel (each)

Replace caster wheel bearings and adjust

(per caster)

Section Total

E2226

E2210

E2225

E2210

(07) Armrests



Replace armrest sidepanel (each)

Wheelchair access detach adjust armrest

Detach non-adjust height armrest

Detach adjust armrest base

Detach adjust armrest upper

Fixed adjust armrest pair

Section Total

Part

Number

Billing Code

K0108

K0019

K0108

E0973

K0015

K0017

K0018

K0020


Replace elevating legrest assembly, non-powered (each)

Replace adjust angle footplate (each)

Replace large size footplate (each)

Replace standard size footplate each

Replace footrest lower extension tube

Replace footrest upper hanger bracket

Replace footrest complete assembly

Replace elevate legrest low extension

Replace elevate legrest up hanger bracket

Part

Number

Billing Code

E0990

K0040

K0041

K0042

K0043

K0044

K0045

K0046

K0047

Time

Time

Time

# Units

# Units

# Units

23

24


Replace swingaway detach footrest

Replace elevate footrest articulate

Replace loop heel

Replace toe loop/holder (each)

Replace Wheelchair No . 2 footplates

Swinging and detachable cam or latch block device

Part

Number

Billing Code

K0052

K0053

E0951

E0952

E0970

K0108

Adjustment only, legrest/footrest (per side)

Extension of footplate assembly

Swinging and detachable cam or pin lock device

Section Total

Part

Number

(09) Backs

Back upholstery

Replace standard back sling upholstery

ADD for adjustable tension sling

ADD to replace broken screw in back post

(requiring drilling)

Replace solid back insert

K0739

K0739

Billing Code

E0982

K0108

K0108

E0992

Back Posts, manual

Non-folding, one post

Non-folding, both posts

Folding, one post

Folding, both posts

Powered backs

Replace 1 back post

Replace both back posts or back frame assembly

Replace actuator

K0108

K0108

K0108

K0108

K0108

K0108

K0108

Time

Time

# Units

# Units

Replace push handle grips (pair)

(See Section 11, Seating Systems (reclining back)

Section Total

(10) Seats

(standard sling or basic insert)

Replace seat upholstery

Replace van or captain type seat

Section Total

(11) Seating Systems

Tilt only (powered)

Replace tilt seating system assembly

Replace/repair actuator cable only

Part

Number

Part

Number

K0108

Billing Code

E0981

K0108

Billing Code

E1002

K0108

Reclining back, powered

Replace power seat tilt

Replace power seat recline

Replace power seat recline mechanism

Replace actuator (check alignment, travel stops, any evidence of binding, includes labor to replace cable if required)

Replace shear actuator

Replace/repair actuator cable only

Tilt with recline (powered)

Replace power seat combo without shear

Replace power seat combo with shear

Replace power seat combo power shear


Replace/repair actuator cable only (each)

Powered legrest

Replace elevating legrest (each)

E1002

E1003

E1004

K0108

K0108

K0108

E1006

E1007

E1008

K0108

K0108

E1010

Time

Time

# Units

# Units

25


Replace/repair actuator cable only (each)

Replace lateral trunk supports (each)

Replace headrest assembly

Replace headrest pad

Replace head rest extension

Section Total


Replace all plastic/rubber parts (less tires)

Replace and glue on post grips

K0108

K0108

K0956

K0108

E0955

E0966

Part

Number

Billing Code

K0108

K0108

Complete cleaning and disinfecting per OSHA

With no rust or corrosion

Minor rust or corrosion

ADD for removal broken/stripped screw

(drill and tap)

ADD for removal broken/stripped bolt

(drill and tap)

Section Total

Section 1 Total

Section 2 Total

Section 3 Total

Section 4 Total

Section 5 Total

Section 6 Total

Section 7 Total

Section 8 Total

Section 9 Total




Grand Total

K0739

K0739

K0739

K0739

Time # Units

26

USREH-PW001


K0462 Billing for loaner equipment

Medicare pays up to one month rental for loaner equipment while patient- OWNED equipment is being repaired .

1 . No modifiers required

2 . Narrative needs to state “loaner K0823 while patient-owned equipment is being

repaired took greater than one day to repair because parts on order”

{loanK0823ptondK0823took>1dpartsordered}

3 . This code can be used when any item is being repaired that the patient

owns (CPAP/BiPAP/Hospital bed/Hoyer lift/Manual W/C/any DME item as long

as it is not on rental)

4 . Repair and Maintenance

5 . CMS Manual System, Pub . 100-2, Medicare Benefit Policy Manual,

Chapter 15, §§110 .2 & 110 .4

6 . Under the circumstances specified in the Medicare Benefit Policy Manual,

payment may be made for repair, maintenance, replacement, and delivery of

medically required DME that the beneficiary owns or is purchasing, including

equipment that had been in use before the user enrolled in Part B of the

Medicare program . In addition, payments for repair and maintenance may not

include payment for parts and labor covered under a manufacturer’s or

supplier’s warranty .

The K0462 does not have to be on same claim but it is always best to do so .

K0739, the labor code, should be billed on first line with a narrative breakdown of the units of labor .

K0462 would be billed on the second line with a narrative of item description .

Then the parts would be billed with proper modifiers and units .

Example: E0955NURBKX 1

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Pointers on repairs

Repairs for patient-owned equipment are covered if the item is still a medical necessity under

Medicare guidelines . There are many power wheelchairs out there that were never medically necessary under Medicare guidelines, so be sure you have documentation for both initial and continued need .

1 . Establish primary insurance .

2 . Establish who paid for the item (wheelchair, concentrator, nebulizer

or any type of DME)

3 . If paid for by Medicare is the item still (was it) medically necessary?

4 . If the wheelchair or other item was provided by a company other than yours,

you should verify all information, including the code billed .

5 . Make sure you have documentation of medical necessity on file before billing .

6 . Make sure you know that the item was a purchase and not a rental . Even

though items are now capped at 13 months, there could still be some items

remaining on maintenance and service .

Here is how you bill:

K0739 – 1 unit equals 15 minutes -- Labor code

K0462 – This is the code to use for the loaner equipment that you give the patient while their equipment is being repaired . Medicare will pay for up to one-month rental for a loaner chair

(or other item) while patient-owned equipment is being repaired .

Bill the proper code for the item being replaced with proper modifiers .

Example: E0973NURTRB for replacement (repair) of right armrest .

If no code, then bill the miscellaneous code (K0108) for wheelchairs and POVs .

If an item is being billed under the E1399/K0108, or any miscellaneous code, the same information is needed: Name, make, model and MSRP of item being replaced and documentation of the base item and statement that patient continues to need .

Documentation needed: (continued need from medical records)

1 . The first statement needs to be that this is repair for patient-owned Name_______

Make_______ Model #__________ purchased by __________ in 00/00/0000 . Patient (use first name) is a quad and requires a power wheelchair for all mobility .

2 . K0108 code needs the name, make, model and MSRP and why it is still medically necessary . Example: K0108 replacement _______ by Name _______ Make ________ Model #

__________ MSRP is $200 .

*

Go to http://www .palmettogba .com/ for current updates and other references .

*Please verify labor rates for your state prior to billing .

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Repair labor billing and payment policy

Effective for dates of service on or after April 1, 2009, the Durable Medical Equipment

Medicare Administrative Contractors (DME MACs) are instituting a billing and payment policy for common repairs based on standardized labor times . This applies to non-rented and out-ofwarranty items . This effective date coincides with the effective date of the new code for repairs for non-oxygen equipment - K0739 (REPAIR OR NONROUTINE SERVICE FOR DURABLE

MEDICAL EQUIPMENT OTHER THAN OXYGEN REQUIRING THE SKILL OF A TECHNICIAN,

LABOR COMPONENT, PER 15 MINUTES) . One unit of service = 15 minutes . Code E1340 is no longer valid for repairs for dates of service on or after April 1, 2009 .

The following table contains repair units of service allowances for commonly repaired items .

Units of service include basic troubleshooting and problem diagnosis . Suppliers are reminded that there is no Medicare payment for travel time or equipment pickup and/or delivery .

Type of Equipment

Power Wheelchair

Power Wheelchair

Power Wheelchair

Power Wheelchair

Power or Manual Wheelchair

Power or Manual Wheelchair

Power Wheelchair

Manual Wheelchair

Hospital Bed

Hospital Bed

CPAP

Seat Lift

Seat Lift

Patient Lift

Part Being Repaired/

Replaced

Batteries

(includes cleaning and testing)

Joystick (includes programming)

Charger

Drive wheel motors (single/pair)

Wheel/Tire

(all types, per wheel)

Armrest or armpad

Shroud/cowling

Anti-tipping device

Pendant

Headboard/footboard

Blower Assembly

Hand Control

Scissor mechanism

Hydraulic Pump

Allowed Units of Service

(USO)

2

2

2

2/3

1

2

3

2

2

2

1

2

1

2

Medicare States:

Suppliers may only bill the allowable units of service listed in the above table for each repair, regardless of the actual repair time . Claims for repairs must include narrative information itemizing each repair and the time taken for each repair . Suppliers are also reminded that Medicare does not pay for repairs to capped rental items during the rental period or items under warranty .

Remember to bill your actual units. If a denial or audit is received it can be appealed.

Make sure your staff documents all repairs in case of audit.

Posted on 2/25/09

______________________________________________________

Keeping accurate records for your time spent on reports allows for cost tracking in your repair shop . All jobs should be costed .

60 - Payment for delivery and service charges for durable medical equipment

(Rev. 1, 10-01-03) B3-5105

Delivery and service are an integral part of oxygen and durable medical equipment (DME) suppliers’ costs of doing business . Such costs are ordinarily assumed to have been taken into account by suppliers (along with all other overhead expenses) in setting the prices they charge for covered items and services . As such, these costs have already been accounted for in the calculation of the fee schedules . Also, most beneficiaries reside in the normal area of business activity of one or more DME supplier(s) and have reasonable access to them .

Therefore, DME carriers may not allow separate delivery and service charges for oxygen or

DME except as specifically indicated in §§90 or in rare and unusual circumstances when the delivery is not typical of the particular supplier’s operation .

For example, there may be situations in which it is necessary for a DME dealer to incur extraordinary delivery expenses in order to meet the needs of beneficiaries living in remote areas that are not served by a local dealer or when a local dealer is temporarily out of stock of required oxygen or equipment . For example, DME carriers may recognize a reasonable separate delivery charge when the supplier must deliver an item of DME outside its normal area of business activity and the beneficiary does not have access to a supplier whose location is nearer .

When a supplier delivers oxygen or DME outside the area in which he/she normally does business, but the item could have been obtained locally, carriers may allow any separate additional delivery charge only to the extent that it does not raise the total payment for the oxygen or DME above the local fee schedule .

When a separate charge can be allowed for delivery/service, carriers base the amount

(based on mileage or a flat rate) on all of the relevant circumstances, including:

• The time and distance traveled;

• The actual additional expenses incurred by the supplier;

• The type and quantity of equipment or oxygen delivered;

• The supplier’s customary charge under such circumstances;

• The prevailing charges in the locality under such circumstances; and

• Delivery charges made elsewhere in similar localities. Any separate delivery charges recognized because of unusual circumstances may, of course, be paid for only for deliveries that have actually been made .

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60 - Payment for delivery and service charges for durable medical equipment

(Rev. 1, 10-01-03) B3-5105 (continued)

Suppliers must be advised in the carrier service areas to bill a separate delivery charge only in those rare situations in which “unusual circumstances” were encountered . Information issuances should be used to advise DME suppliers of the need to fully document unusual circumstances on claims/bills for separate delivery charges . If a supplier, nevertheless, routinely itemizes delivery charges, carriers may consider payment for the charges to be included in the fee for the equipment .

06-89 COVERAGE AND LIMITATIONS 2100.4

Maintenance – Routine periodic servicing, such as testing, cleaning, regulating and checking of the beneficiary’s equipment is not covered . Such routine maintenance is generally expected to be done by the owner rather than by a retailer or some other person who charges the beneficiary . Normally, purchasers of DME are given operating manuals which describe the type of servicing an owner may perform to properly maintain the equipment . Thus, hiring a third party to do such work is for the convenience of the beneficiary and is not covered .

However, more extensive maintenance which, based on the manufacturers’ recommendations, is to be performed by authorized technicians, is covered as repairs .

This might include, for example, breaking down sealed components and performing tests which require specialized testing equipment not available to the beneficiary .

Replacement – Replacement of equipment that the beneficiary owns or is purchasing is covered in cases of loss or irreparable damage or wear and when required because of a change in patient’s condition . Expenses for replacement required because of loss or irreparable damage may be reimbursed without a physician’s order when in the judgment of the carrier the equipment as originally ordered, considering the age of the order, still fills the patient’s medical needs . However, claims involving replacement equipment necessitated because of wear or a change in the patient’s condition must be supported by a current physicians order . (See §2306D in regard to payment for equipment replaced under a warranty .)

Repair shop pointers

Repair shops are key components of a successful Rehab/DME business .

A properly staffed and efficient repair center establishes Rehab or general DME suppliers as experts in their field .

Your repair shop should be accessible and hours should be clearly posted .

A good repair center will create additional sales opportunities as well as establish your company as someone who can be trusted .

Continuing education of your sales force, your order intake personnel and your repair staff is imperative .

Everyone needs to know the basic information that is required from the beginning .

1 . Collect funding information .

If you know where the money is coming from before you start, you can process the repair and payment without loss .

Your customer service staff should also be thoroughly trained on all types of funding . They need to understand the equipment, too .

They need to be friendly and helpful .

They need to be presentable .

All information needs to be collected before an appointment is made .

2 . Once funding is established, set up an appointment and have an experienced technician do the evaluation and cost analysis . This will save you time and money and help your bottom line .

Submit for prior authorization, if required, before any repairs are completed .

Do the repair . Make sure all items are entered on the work sheet . Don’t let the technicians become lax on keeping track of items used . One bracket, bolt, etc . may be cheap, but 100 brackets, bolts, etc . can add up .

Submit for funding with the proper coding and information, including a breakdown of labor time . The name, make and models of pieces are very important . It is imperative for the repair staff to make legible notes and give the information to billing staff in a format that they can follow .

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Steps to easy power wheelchair maintenance

• Inspect it:

• Check for broken, missing and loose pieces .

• Inspect the frame for any damage, bent tubes, broken welds . Inspect the upholstery

for tears or splits . Check seat for foam wear .

• Keep it clean:

• Wipe any excess dirt or grime from your wheelchair . Dirt and grime can

compromise the smooth movement, create rust and damage moving parts .

• You can use a general purpose cleaner to wipe down the frame, wheels, tires and

hand rims on the chair .

• Wipe the upholstery clean, but do not use petroleum-based cleaners because they

can damage the upholstery .

•Keep it lubricated:

• All pivot points on the chair need to be lubricated regularly with a multi-use

lubricant to prevent dust and repel moisture .

• Keep it tight:

• Check no less than once a month for loose nuts and bolts .

• Check tires:

• Are the tires showing excessive wear? If so, they need to be replaced .

• Check for loose or damaged spokes .

• Make sure all tires are inflated correctly . Flat or low tires use up excess battery

power and make wheelchairs hard to operate .

• Check wheel locks to ensure they are tight . They are essential for safe patient

transfer . Inspect closely to make sure they are not bent .

• Check batteries:

• Make sure batteries are properly installed .

• Check for proper charging and ensure the charger is functioning correctly .

• Check all cables to ensure they are tight and there is no corrosion on the terminals .

See the following Power Wheelchair Service Checklist .

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Power wheelchair service checklist:

Customer Name: ______________________________ Date of Service: _______________________________

Manufacturer: ________________________________

Repair Tech: __________________________________

Make/Model: _________________________________

Serial #: ______________________________________

Description of Service:

Upholstery: Check for sags, tears and splits, check foam for wear

Tires: Check for excessive wear/tire pressure

Spokes/Rims: Check tightness and for broken/missing spokes

Wheel release lever: Check for tightness and adjust

Bearings: Check for condition and adjust all bearings

Front riggings: Check foot plates/ legrest/springs/straps

Frame: Check for damage, bent tubes, broken welds

Remove arms: Adjust height/inspect

Folding chairs: Ensure proper folding

Check tips and grips for wear

Verify all accessories are correct and properly installed

Check seat/back if aftermarket for wear and proper installation

Ensure you have cleaned the chair thoroughly and properly

Check batteries for proper charge and any leaks

Ensure battery charger is working properly

Joystick/modules and battery box are mounted securely

Make sure kill switch is present and operable

Make sure chair is operating properly in all modes/directions

Alternate drives test functionality

Tilt/Recline: lubricated and tested

Condition Adjusted Replaced/Cost Repair/Cost

COMMENTS:

This wheelchair has been carefully inspected according to manufacturer’s specifications . If you have any questions or comments regarding this equipment, please contact our Customer Service Staff at your earliest possible convenience . Thank you for the opportunity to serve you .

Inspection ____________________________________________________________ Completed Repairs __________________________________________________

Technician_________________________________ Date __________________________ Technician_________________________________ Date ____________________

Customer_________________________________ Date __________________________ Customer_________________________________ Date ____________________

Steps to easy manual wheelchair maintenance:

• Inspect It:

• Check for broken, missing and loose pieces on the chair.

• Inspect the frame for any damage, bent tubes, broken welds.

Inspect the upholstery for sagging, tears or splits .

• Keep it clean:

• Wipe any excess dirt or grime from your wheelchair, dirt

and grime can compromise the smooth movement, create rust and

damage moving parts .

• You can use a general purpose cleaner to wipe down the frame,

wheels, tires and hand rims on the chair .

• Wipe the upholstery clean. Do not use petroleum-based cleaners

on upholstery as these can damage the upholstery .

• Keep it Lubricated:

• All pivot points on the chair need to be lubricated regularly –

this can be done using a multi-use lubricant to prevent dust

and repel moisture .

• Keep it tight:

• Check no less than once a month for loose nuts and bolts.

• Check tires:

• Are the tires showing excessive wear? If so they need to be replaced.

• Check for loose or damaged spokes.

• Make sure all tires are inflated correctly. Flat or low tires use up

excess energy for user, making wheelchairs hard to push .

• Check wheel locks to ensure they are tight because they are

essential for safe patient transfer .

See the following Manual Wheelchair Service Checklist .

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Manual wheelchair service checklist:

Customer Name: ______________________________

Manufacturer: ________________________________

Date of Service: _______________________________

Make/Model: _________________________________

Repair Tech: __________________________________ Serial #: ______________________________________

Description of Service:

Upholstery: Check for sags, tears & splits

Tires: check for excessive wear/ tire pressure

Spokes/Rims: Check tightness

& for broken/missing spokes

Handrims/Hardware: Check tightness/damage

Wheel lock/Grade Aids: Check for tightness

Bearings: Check for condition

& adjust all bearings

Front riggings: Check foot plates/springs/straps

Frame: Check for damage, bent tubes, broken welds

Remove arms: adjust height/ inspect

Folding chairs: ensure proper folding

Check tips and grips for wear

Check all accessories for proper installation

Check seat/back if aftermarket for wear & proper installation

Make sure you have cleaned the chair properly

Condition Adjusted Replaced/Cost Repair/Cost

COMMENTS:

This wheelchair has been carefully inspected according to manufacturer’s specifications . If you have any questions or comments regarding this equipment, please contact our Customer Service Staff at your earliest possible convenience . Thank you for the opportunity to serve you .

Inspection ____________________________________________________________ Completed Repairs __________________________________________________

Technician_________________________________ Date __________________________ Technician_________________________________ Date ____________________

Customer_________________________________ Date __________________________ Customer_________________________________ Date ____________________

Job classification section

Rehab equipment service technician

General: Responsible for the repair and maintenance of all company-owned rental equipment and customer-owned equipment in need of repair . Maintains appropriate documentation, establishes, implements and monitors policies and procedures regarding the servicing of equipment and delivery of same . Instructs patients on proper use and care of equipment (except transfer techniques); must have high level of product knowledge on all respiratory equipment and DME. Maintains assigned company vehicle and repair shop; other tasks as requested .

Qualifications

Physical:

1 . In an average 8-hour day, the employee lifts/carries up to 65 pounds frequently .

2 . In an average 8-hour day, the employee stands/walks 7 hours .

3 . In an average 8-hour day, the employee sits 1 hour .

4 . In an average 8-hour day, the employee drives 0 hours .

5 . The employee lifts/carries up to 100 pounds maximum .

6 . Must be clean and neat in personal appearance .

Education:

1 . High school diploma or G .E .D . equivalent preferred .

2 . Previous repair experience preferred .

Experience/Knowledge/Personality:

1 . Able to work independently with minimal supervision .

2 . People-sensitive characteristics with a desire to help others .

3 . Able to function as a polite and cooperative team member with a positive attitude .

4 . Must be detail-oriented .

5 . Excellent driving record .

6 . Mechanical abilities required .

7 . Computer experience preferred .

8 . Able to maintain confidentiality .

9 . Good communication skills .

10 . Must be able to read, write and speak English fluently .

On Call:

1 . Periodically available for non-office hours .

2 . Willing to be trained in pertinent areas of equipment/supplies .

3 . Available for home/office visits .

-continued-

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-continued-

Responsibilities

Responsible for:

1 . Maintaining an accurate and efficient workflow for processing rehab orders and

related documentation .

2 . A working knowledge of computer system to include order entry, inventory, notes,

report writing and accounts receivable .

3 . Assisting with obtaining all required documentation, authorizations, verifications,

and waivers for proper payment of rehab products . Responsible to respond in a

timely manner to requests for additional information, and to investigate problems

and resolve with appropriate staff .

4 . Assisting with placing orders for wheelchair and accessories through

materials department .

5 . Repairing specialty or high-end wheelchairs, which includes setting schedule

for pickup, delivery, providing loaner - p .r .n ., ordering replacement parts, repairing,

documenting repairs for billing, and making appropriate notes in computer system .

6 . Keeping current on third party reimbursement issues and

documentation requirements .

7 . Setting up appointments for fittings, deliveries, etc . in conjunction with customer

service staff and Rehab Specialist .

8 . Assisting with deliveries and setups as requested by Rehab Specialist

and/or branch manager .

9 . Assisting with inventory control of rehab products and assuring that warehouse

is a safe, organized, efficient environment .

9 . Filing charts and contents accurately and in a timely manner .

10 . Maintaining confidentiality about all customer charts and secure files at close of business day .

11 . Auditing customer charts according to company guidelines . Assist with report completion as requested .

12 . Providing support and assistance to other departments as needed .

13 . Maintaining clean, neat, and orderly work area .

14 . Being on call per company policy .

15 . Attending in-store meetings .

16 . Performing other duties as deemed appropriate by management .


Rehabilitation specialist

General: The Rehab Specialist is responsible for fitting, adjusting, and assembling rehab and other high-tech equipment . Provides instructions to patients and referral sources, is knowledgeable about third party reimbursements, and markets the company’s rehab services .

Qualifications

Physical:

1 . In an average 8-hour day, the employee lifts/carries up to 65 pounds frequently .

2 . In an average 8-hour day, the employee stands/walks 3 hours .

3 . In an average 8-hour day the employee sits 2 hours . (These hours include up to 2

hours of data entry/phone work)

4 . In an average 8-hour day, the employee drives 3 hours .

5 . The employee lifts/carries up to 85 pounds maximum .

6 . Must be clean and neat in personal appearance .

Education:

1 . High school diploma .

2 . Two years’ rehab experience or approved training .

Experience/Knowledge/Personality:

1 . Able to function as a polite and cooperative team member with a positive attitude .

2 . Good computer skills preferred .

3 . Good oral and written communication skills .

4 . Must be detail-oriented .

5 . People-sensitive characteristics with a desire to help others .

6 . Able to work independently .

7 . Certification may be required .

8 . Able to maintain confidentiality .

On Call:

1 . Periodically available for non-office hours .

2 . Willing to be trained in pertinent areas of equipment and supplies .

3 . Available for home/office visits .

4 . Good driving record .

-continued-

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-continued-

Responsibilities

Responsible for:

1 . Responsible to set up appointments for fittings, delivery, etc . in conjunction with

customer service staff .

2 . Responsible to do fittings and complete all appropriate paperwork .

3 . Responsible to obtain all required authorizations, verifications, and waivers for

proper payment, through appropriate staff per policy and procedure .

4 . Responsible to place order for wheelchair and accessories through

materials department .

5 . Responsible to deliver equipment or make arrangements for delivery and verify fit,

equipment function and performance, with complete and accurate documentation .

6 . Responsible for knowledge of third party reimbursement issues and

documentation requirements .

7 . Responsible for safe operation and routine care of company vehicle .

8 . Assist with other deliveries and setups as requested by branch manager .

9 . Provide accurate, timely information to controller for commission calculation

on a quarterly basis .

10 . Assist with inventory control .

11 . Assist with on-call per request of branch manager and time constraints .

12 . Attend in-store meetings .

13 . Perform other duties as deemed appropriate by management .


Rehabilitation engineer senior

Characteristic Duties and Responsibilities

• Evaluation of patients for mobility and seating systems.

• Working in a team environment.

• The team will be composed of patient, caregiver, physician, therapist, case manager

• Setup of equipment for simulation.

• Completing equipment order forms.

• Creating pricing quotations.

• Working with Rehabilitation Service Technician (RST) on final assembly

and quality assurance .

• Delivery and fitting equipment.

• Communicating with the rehab team on any changes of equipment or patient status.

• Patient follow-up to ensure that the goals of the service plan are met.

• Communicating insurance coverage benefits, limitations and other issues.

• Functional oversight of various operational and/or clinical duties.

• Participates in the development and implementation of policies and procedures.

• Development, monitoring and reporting on relevant metrics for oversight areas.

Physical requirements

• Ability to read, write, speak and comprehend English.

• Functional visual acuity and hearing for accurate assessment and recording of

patient observations and information .

• Manual dexterity to perform required procedure activity proficiently and safely.

• Ability to lift up to 75 pounds to perform transfer of medical, surgical

equipment and supplies .

Working conditions and occupational hazards

• Performs assigned duties in assigned locations.

• Risk of exposure to infectious diseases and blood-borne pathogens through

patient contact .

• Drives a delivery vehicle to various locations in all weather conditions on

a regular basis .

Qualifications

• RESNA ATS/P certified.

• Active NRRTS membership with CRTS credentials.

• Three to five years’ rehabilitation experience (preferred) may include clinical,

technician, or RTS .

• A working knowledge of insurance/billing requirements and reimbursement levels.

• Excellent communication skills.

• A strong desire to maintain a high level of quality standard or practice.

• Willing and able to attend seminars and trade shows to maintain certifications

and NRRTS membership .

Education

• Associate degree in physical medicine or related curriculum (minimum).

• Bachelor’s degree in physical medicine or related curriculum (preferred).

• Attendance at advanced seating and mobility seminars.

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Job Classification Section

Rehabilitation engineer

Characteristic Duties and Responsibilities

• Evaluation of patients for mobility and seating systems.

• Working in a team environment.

• The team will be composed of patient, caregiver, physician, therapist, case manager

• Setup of equipment for simulation.

• Completing equipment order forms.

• Creating pricing quotations.

• Working with Rehabilitation Service Technician (RST) on final assembly and

quality assurance .

• Delivery and fitting equipment.

• Communicating with the rehab team on any changes of equipment or patient status.

• Patient follow-up to ensure that the goals of the service plan are met.

• Communicating insurance coverage benefits, limitations and other issues.

Physical requirements

• Ability to read, write, speak and comprehend English.

• Functional visual acuity and hearing for accurate assessment and recording of

patient observations and information .

• Manual dexterity to perform required procedure activity proficiently and safely.

• Ability to lift up to 75 pounds to perform transfer of medical, surgical equipment

and supplies .

Working conditions and occupational hazards

• Performs assigned duties in variety of locations.

• Risk of exposure to infectious diseases and blood-borne pathogens through

patient contact .

• Drives a delivery vehicle to various locations in all weather conditions on a

regular basis .

Qualifications

• RESNA ATS certified or RESNA eligible within two years.

• Active NRRTS membership or eligible within minimum required time frame.

• Three to five years’ rehabilitation experience (preferred) may include clinical,

technician, or RTS .

• A working knowledge of insurance/billing requirements and reimbursement levels.

• Excellent communication skills.

• A strong desire to maintain a high level of quality standard or practice.

• Willing and able to attend seminars and tradeshows to maintain certifications

and NRRTS membership .

Education

• High school diploma or equivalency (minimum).

• Associate degree in physical medicine or related curriculum (preferred).

• Attendance at seating and mobility seminars.

Rehab Service Technician Competency

Name: ______________________________________

INSTRUCTIONS: Complete this skill sheet . Use the “comments” section to state comments or issues .

Skill Level Legend: 1 = No contact w/equipment or this situation . No knowledge of procedure .

2 = Understand procedure and situation but never performed task .

3 = Have performed this task infrequently and would need supervision .

4 = Have performed this task frequently and can perform independently .

For competency testing review skills of staff and grade accordingly .

Legend: E = Excellent

S

N = Needs Improvement

N/A = Not Applicable

Competency testing is completed on hire and on an annual basis.

SKILL LEVEL Skills

TOPIC

Communication skills

1 2 3 4 Review COMMENTS

Verbal

Written

Medical terminology

Typing __________ WPM

Computer skills

Computer programs

_________________________________

Order building/cognitive assessment/fitting

Troubleshooting

Electromechanical ability

Patient

Rights and responsibilities

Complaint Procedure

Source of referrals

Medicare coverage criteria

Medicaid coverage criteria

Private insurance procedures

Managed care contracts and authorizations

Billing process

CMN auditing

Infection control procedures

Occurrence reporting

Handling complaints

-continued-

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-continued-

TOPIC

Delivery/setup/troubleshooting/fitting

Tilt/recline systems

Batteries

Drive control programming

Drive system interfaces

Remote electronics

Integral electronics

Elevating seats

Power seating systems

Power wheelchairs /cushions/ seating

Lifts/traction/trapeze

Walk aids/bath aids

Other equipment as stated

Proper body mechanics and lifting

Proper vehicle use and loading

Specialty Interest Area:

1

EQUIPMENT

SKILL LEVEL

2 3 4

Skills

Review

Comments (any additional skills) :

Attachments (any certificates of completion from participation in technical repair courses) :

COMMENTS

Signature: ___________________________________________ Date: ___________________________

Reviewed by: _________________________________________ Date: ___________________________

Assistive Technology Professional Competency

Name: ______________________________________

INSTRUCTIONS: Complete this skill sheet . Use the “comments” section to state comments or issues .

Skill Level Legend: 1 = No contact w/equipment or this situation . No knowledge of procedure .

2 = Understand procedure and situation but never performed task .

3 = Have performed this task infrequently and would need supervision .

4 = Have performed this task frequently and can perform independently .

For competency testing review skills of staff and grade accordingly .

Legend: E = Excellent

S

N = Needs Improvement

N/A = Not Applicable

Competency testing is completed on hire and on an annual basis.

TOPIC

Communication skills

1

SKILL LEVEL

2 3 4

Skills

Review COMMENTS

Verbal

Written

Medical terminology

Typing __________ WPM

Computer skills

Computer programs

_________________________________

Order intake procedures

Order building /fitting/cognitive assessment

Diagnosis and ICD-9 codes

Patient

Acceptance criteria

Rights and responsibilities

Complaint procedure

Source of referrals

Medicare coverage criteria

Medicaid coverage criteria

Private insurance procedures

Managed care contracts and authorizations

Billing process

CMN auditing

Infection control procedures

Handling complaints

Electro-mechanical ability

Troubleshooting capability

-continued-

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-continued-

TOPIC

Cash handling

Occurrence reporting

Handling complaints

1

SKILL LEVEL

2 3 4

TOPIC

Delivery/setup/troubleshooting/ fitting

Batteries

Tilt/recline systems

Drive control programming

Drive system interfaces

Remote electronics

Integral electronics

Elevating seats

Power seating systems

Wheelchairs /cushions

Lifts/traction/trapeze

Walk aids/bath aids

Other equipment as stated

Proper body mechanics and lifting

Proper vehicle use and loading

Specialty Interest Area:

1

EQUIPMENT

SKILL LEVEL

2 3 4

Skills

Review

Skills

Review

Comments (any additional skills) :

Attachments (any certificates of completion from participation in technical repair courses) :

COMMENTS

COMMENTS

Signature: ___________________________________________ Date: ___________________________

Reviewed by: _________________________________________ Date: ___________________________

Employee performance evaluation

Position: Service Technician

Employee: _______________________________________ Date: __________________

Rating Scale:

0 = Performance is unacceptable, immediate improvement required

1 = Performs as expected occasionally, needs reinforcement

2 = Performs as expected most of the time

3 = Performance is exemplary, exceeds expectations

Quality of Work:

1) Performs repairs efficiently and accurately .

2) Follows all driving rules and regulations, including DOT requirements .

3) Follows all infection control protocols and universal precautions .

4) Utilizes proper safety and personal protection devices at all times as necessary .

5) Obtains complete required signatures and dates on all forms given to clients .

6) Provides complete documentation whenever required to document any unusual circumstance

regarding a delivery or call .

7) Greets clients and visitors in courteous manner by introducing self and calling clients by name .

8) Performs daily vehicle inspections .

Supportive documentation and comments: ____________________________________________________

___________________________________________________________________________________________

____________________________________________________________________________________________

__________________________________________________________________________________________

Total points: __________ Average: __________

Quantity of Work:

1) Completes all assigned work during scheduled shift .

2) Is ready for morning departure unless unusual circumstances arise and cause delays .

3) Performs minor repairs on manual equipment consistently and effectively .

-continued-

49

50

-continued-


___________________________________________________________________________________________

____________________________________________________________________________________________

__________________________________________________________________________________________


Knowledge of Job: 0 1 2 3

1) Demonstrates understanding of Universal Precautions and clearly understands infection control

policies for cleaning equipment .

2) Demonstrates an understanding of all manual equipment delivered and a basic operating

knowledge of power equipment .

3) Understands and abides by all state driving laws and regulations .

4) Demonstrates awareness and understanding of job description and job responsibilities .

5) Attends and contributes to in-services .

6) Understand basic repairs to manual equipment .


___________________________________________________________________________________________

____________________________________________________________________________________________

__________________________________________________________________________________________


Judgment and Decision Making:

1) Consults with supervisor when unusual or urgent situations occur .

Does not make impulsive decisions .

2) Decisions are always based on policies and procedures .


___________________________________________________________________________________________

____________________________________________________________________________________________

__________________________________________________________________________________________


-continued-

-continued-

Reliability and Initiative:

1) Arrives on time at start of the workday .

2) Returns promptly from lunch/breaks .

3) Provides proper notification for scheduled absences .

4) Follows procedures for reporting tardiness .

5) Attends to personal affairs without letting them disrupt work schedule .

6) When requested, is willing to work additional hours .

7) Recognizes the needs for and performs additional, unassigned tasks .

8) Helps co-workers .

9) Maintains work area in an orderly manner .


___________________________________________________________________________________________

____________________________________________________________________________________________

__________________________________________________________________________________________


Safety and Infection Control:

1) Is knowledgeable on infection control practices .

2) Demonstrates knowledge of safety policies and procedures .

3) Completely understands and can describe emergency/disaster procedures (e .g ., what to

do in the event of a disaster)


___________________________________________________________________________________________

____________________________________________________________________________________________

__________________________________________________________________________________________


Service Technician Assessment Report

51

52

N/O 1

Not Observed Unsatisfactory

2

Needs

Improvement

3

Meets

Expectations

4

Exceeds

Expectations

5

Exemplary

Assessment Date: ______________________

General: Appearance: Reflects professionalism and adherence to dress code as stated in the company’s policy and procedures manual, personnel policy section .

N/O 1 2 3 4 5

Comments:

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Dependability: is punctual and works scheduled hours (part-time/full-time), with minimum absence and/or requested personal time off .

N/O 1 2 3 4 5

Comments:

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Responsibility:

Demonstrates accountability and trustworthiness as a staff member/ representative of

N/O 1 2 3 4 5

Comments:

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Learning Aptitude: Capacity for learning and general suitability .

-continued-

-continued-

N/O 1 2 3 4 5

Comments:

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

General:

Retention: Ability to recall and apply learned and experienced technical skills in the performance of assigned tasks .

N/O 1 2 3 4 5

Comments:

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Communication skills, written:

N/O 1 2 3 4 5

Comments:

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Communication skills, oral:

N/O 1 2 3 4 5

Comments:

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

-continued-

53

54

-continued-

Performance:

Productivity, in shop and field:

N/O 1 2 3 4 5

Comments:

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Understanding/Execution of Return Authorization (R.A.) procedures:

Coordination, proper routing and filing of return authorization forms .

N/O 1 2 3 4 5

Comments:

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Understanding/Execution of Service Repair Orders (SRO) and Service Repair Requests (SRR): Generation and proper routing of forms associated with repair orders .

N/O 1 2 3 4 5

Comments:

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Demonstrated ability in determining client pay sources:

2

-continued-

3 N/O 1 4 5

Comments:

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Understanding, and ability to explain costs, prior authorization and other required information, to clients:

N/O 1 2 3 4 5

Comments:

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Skills; Troubleshooting/Evaluation of Equipment:

Demonstrated ability to troubleshoot and repair various makes and models, manual wheelchairs:

N/O 1 2 3 4 5

Comments:

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Demonstrated ability to troubleshoot and repair various makes and models, power mobility bases, MECHANICAL:

N/O 1 2 3 4 5

Comments:

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

-continued-

55

56

-continued-

Skills: Troubleshooting/Evaluation of Equipment:

Demonstrated ability to troubleshoot and repair various makes and models, power mobility bases, ELECTRONICS and ELECTROMECHANICAL:

N/O 1 2 3 4 5

Comments:

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Scooter evaluation and repair, various makes and models,

MECHANICAL, ELECTROMECHANICAL and ELECTRONICS:

N/O 1 2 3 4 5

Comments:

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Evaluation and repair of lift chairs, various makes and models,

MECHANICAL and ELECTROMECHANICAL:

N/O 1 2 3 4 5

Comments:

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Demonstrated ability to troubleshoot and repair hospital beds, various makes and models, MECHANICAL and ELECTRO-MECHANICAL:

-continued-

-continued-

N/O 1 2 3 4 5

Comments:

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Demonstrated ability to setup, operate and instruct oxygen equipment, especially oxygen concentrators, oxygen tanks and their associated valves and fittings:

N/O 1 2 3 4 5

Comments:

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Demonstrated ability to properly install and repair various seating systems and their related components:

N/O 1 2 3 4 5

Comments:

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Overall technical skills and aptitude:

N/O 1 2 3 4 5

Comments:

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

-continued-

57

58

Performance evaluation summary sheet

Position: _____________________________________

Quality of Work

Quantity of Work

Knowledge of Job

Judgment and

Decision

Making

# of

Points

# of

Standards

Average

Reliability and

Initiative

Overall

Rating

Developmental goals and training needs: _____________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Employee comments: ________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Supervisor comments: _______________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Supervisor signature: ____________________________________ Date: ____________

Employee signature: _____________________________________ Date: ____________

U.S. Rehab Exclusive Vendors

U.S. Rehab has partnerships with top-rehab vendors for quality products, services and preferred pricing.

AbleNet, Inc

800-322-0956

www.ablenetinc.com

Specializes in educational and assistive technology solutions to help children and adults with disabilities lead productive and fulfilled lives.

Blue Chip Medical Products, Inc.

800-795-6115

www.bluechipmedical.com

Specializes in therapeutic mattresses, overlays, seating & positioning cushions and patient safety products.

Comfort Company

800-564-9248

www.comfortcompany.com

Specializes in seating and positioning products for geriatric and rehabilitation clients.

Harmar

800-833-0478

www.harmar.com

Specializes in patient lifts, vehicle lifts, stair lifts, vertical platform lifts, incline platform lifts, cargo lifts, bath lifts and ramps.

Innovative Concepts

800-676-5030

www.icrehab.com

Specializes in adaptive seating products and services.

Innovation In Motion

800-327-0681

www.mobility-usa.com

Specializes in power wheelchairs and

Ormesa pediatric products.

Invacare

800-333-6900

www.invacare.com

Specializes in home and long-term care products.

Medical Applications

800-594-9166

www.medicalappsonline.com

Specializes in wheelchair accessories and hardware.

Medical Equipment Services

781-246-0523

www.powerwheelchairelectronicrepairs.com

Specializes in power wheelchair and power chair electronic repairs.

MK Battery

800-372-9253

www.mkbattery.com

Specializes in batteries for HME/mobility; one of the largest sealed lead acid battery providers in North America.

Motion Concepts

888-433-6818

www.motionconcepts.com

Specializes in wheelchair tilt and recline systems.

Permobil

800-736-0925

www.permobil.com

Specializes in high-end power mobility.

PDG: Product Design Group

888-858-4422

www.pdgmobility.com

Specializes in providing better mobility products for people with extra special needs.

PRM: Precision Rehab Manufacturing Inc.

814-725-8731

www.prmrehab.com

Specializes in custom seat and back cushions.

Prism Medical

866-891-6502

www.prismmedicalltd.com

Specializes in safe patient handling.

RAZ Designs Inc.

877-720-5678

www.razdesigninc.com

Specializes in rehab commode shower chairs.

Richardson Products

888-928-7297

www.richardsonproducts.com

Specializes in seating and positioning.

Rifton Equipment

800-571-8198

www.rifton.com

Specializes in pediatric mobility.

The ROHO Group

800-851-3449

www.therohogroup.com

Specializes in DRY FLOATATION ® , from wheelchair cushions to a full line of shape-fitting products.

59

Greg Packer

Vice President

Peggy Walker, RN

Billing and Reimbursement Adviser

Carrie Etten

Administrative Assistant

Elizabeth Cole

Director of Clinical Rehab Services

Standardized Repair and Service Guide

Introduction

Table of Contents

Preface

Repair center criteria

Time Table Conversion

How to use this guide:

Repair questionnaire:

Standard Manual Chair

Folding and Rigid Frame

Standardized repair table with commonly used HCPCS codes:

STANDARD MANUAL CHAIR FOLDING and RIGID FRAME REPAIR

Scooters and POVs

Standardized repair table with commonly used HCPCS codes:

SCOOTERS and POVs

Power Wheelchair

Gearbox/Direct Driven/Belt Drive

Standardized repair table with commonly used HCPCS codes:

POWERWHEELCHAIR – GEARBOX / DIRECT DRIVE / BELT DRIVE

K0462 Billing for loaner equipment

Pointers on repairs

Repair labor billing and payment policy

Medicare States:

60 - Payment for delivery and service charges for durable medical equipment

60 - Payment for delivery and service charges for durable medical equipment

Repair shop pointers

Steps to easy power wheelchair maintenance

Power wheelchair service checklist:

Steps to easy manual wheelchair maintenance:

Manual wheelchair service checklist:

Job classification section

Rehab equipment service technician

Job classification section

Rehabilitation specialist

Job classification section

Rehabilitation engineer senior

Job Classification Section

Rehabilitation engineer

Rehab Service Technician Competency

Service Technician Assessment Report

Responsibility:

General:

Performance:

Skills: Troubleshooting/Evaluation of Equipment:

Performance evaluation summary sheet

U.S. Rehab Exclusive Vendors

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