CMC Complex Rehab Technology Products 3 — Questions and Answers
Question 1: A client with ALS who is losing hand function needs a power wheelchair. Which alternative drive control should be evaluated FIRST given likely progression?
- Head array with proportional control (Correct answer)
- Standard joystick with a T-bar handle
- Sip-and-puff pneumatic switch
- Chin joystick
Correct answer: Head array with proportional control
A head array with proportional control is often the best long-term solution for ALS clients as it provides proportional speed/direction control and remains functional as upper extremity function declines.
Question 2: The Medicare Local Coverage Determination (LCD) for power mobility devices requires that a face-to-face examination be performed by:
- The ATP who conducts the seating evaluation
- A physician, PA, NP, or CNS treating the beneficiary (Correct answer)
- Any licensed healthcare professional familiar with the patient
- The CRT supplier's clinical director
Correct answer: A physician, PA, NP, or CNS treating the beneficiary
Medicare LCD requires the face-to-face examination for power mobility devices to be performed by the treating physician, PA, NP, or CNS.
Question 3: Which type of power wheelchair drive configuration provides the TIGHTEST turning radius, making it most suitable for indoor navigation in tight spaces?
- Rear-wheel drive (RWD)
- Front-wheel drive (FWD)
- Mid-wheel drive (MWD) (Correct answer)
- All-wheel drive (AWD)
Correct answer: Mid-wheel drive (MWD)
Mid-wheel drive wheelchairs have the drive wheels positioned under the user's center of gravity, enabling the tightest turning radius and best indoor maneuverability.
Question 4: In complex seating, 'pelvic obliquity' refers to:
- Anterior-posterior rotation of the pelvis in the sagittal plane
- Lateral tilting of the pelvis where one iliac crest is higher than the other (Correct answer)
- Forward sliding of the pelvis on the seat surface
- Asymmetrical hip flexion contracture
Correct answer: Lateral tilting of the pelvis where one iliac crest is higher than the other
Pelvic obliquity is a lateral (frontal plane) deviation where one side of the pelvis sits higher than the other, often requiring contoured or wedged seating to accommodate.
Question 5: A standing wheelchair is classified under which HCPCS code category?
- K0001–K0009 (manual wheelchair codes)
- E1235–E1236 (heavy-duty wheelchair codes)
- K0835–K0898 (power operated vehicle codes)
- E1161 or K0004 combined with a standing frame code (Correct answer)
Correct answer: E1161 or K0004 combined with a standing frame code
Standing wheelchairs are typically billed using a manual or power wheelchair base code combined with an appropriate standing frame or power standing system add-on code.
Question 6: Under the Medicare competitive bidding program, CRT products were EXEMPTED primarily because:
- CRT products exceed the $1,000 DME threshold for competitive bidding
- CRT requires individualized configuration by credentialed suppliers and cannot be competitively commoditized (Correct answer)
- Medicare Advantage plans cover CRT separately from Part B
- CRT products are classified as prosthetics, not DME
Correct answer: CRT requires individualized configuration by credentialed suppliers and cannot be competitively commoditized
CRT was excluded from Medicare competitive bidding because the individualized, clinical nature of complex rehab technology requires credentialed suppliers and custom fitting that cannot be standardized like commodity DME.
Question 7: A client requires a tilt-in-space manual wheelchair. Which clinical indication BEST justifies this feature?
- The client needs to self-propel long distances outdoors
- The client has poor sitting balance and needs postural support to shift weight and manage pressure (Correct answer)
- The client's caregiver has a back injury and needs easier transfer assistance
- The client's home has narrow doorways requiring a smaller footprint
Correct answer: The client has poor sitting balance and needs postural support to shift weight and manage pressure
Tilt-in-space is clinically indicated when a client lacks the ability to perform independent weight shifts and needs caregiver-assisted pressure relief while maintaining postural alignment.
CMC Complex Rehab Technology Products 3
A client with ALS who is losing hand function needs a power wheelchair.
Which alternative drive control should be evaluated FIRST given likely progression?