CMC Mobility Assessments & Evaluations 3 — Questions and Answers
Question 1: A CMC is completing a LCDs (Local Coverage Determinations) review for a power wheelchair. Which criterion is NOT typically required for Medicare power wheelchair coverage?
- Unable to self-propel a manual wheelchair
- Severe cardiac condition (Correct answer)
- Unable to ambulate in the home
- Cognitive ability to safely operate the device
Correct answer: Severe cardiac condition
While ambulation ability, self-propulsion capacity, and cognitive safety are key Medicare criteria, a cardiac condition alone is not a standalone criterion for power wheelchair coverage.
Question 2: When assessing pressure redistribution needs, which body landmark is most critical to measure for proper cushion selection?
- Elbow width
- Ischial tuberosity width (Correct answer)
- Knee-to-floor height
- Shoulder height
Correct answer: Ischial tuberosity width
Ischial tuberosity width (IT width) is the primary measurement used to select an appropriately sized pressure redistribution cushion.
Question 3: A client with C6 tetraplegia uses a manual wheelchair. Which propulsion pattern is most efficient and reduces upper extremity injury risk?
- Short rapid strokes
- Long smooth semi-circular strokes (Correct answer)
- Push-and-brake alternation
- Alternating one-arm push
Correct answer: Long smooth semi-circular strokes
Long, smooth, semi-circular propulsion strokes reduce peak forces and wrist extension stress, minimizing injury risk for manual wheelchair users.
Question 4: During a vehicle modification assessment, a client with bilateral lower limb amputation reports difficulty with standard pedal controls. Which assessment component should the CMC address FIRST?
- Selecting a hand control type
- Evaluating upper extremity strength and coordination (Correct answer)
- Ordering adaptive driving equipment
- Contacting the DMV
Correct answer: Evaluating upper extremity strength and coordination
Before recommending specific adaptive driving equipment, the CMC must assess the client's upper extremity function to determine which hand control type is appropriate.
Question 5: Which of the following is the correct sequence for a comprehensive mobility evaluation?
- Equipment trial → clinical assessment → goal setting → documentation
- Referral review → clinical assessment → goal setting → equipment trial → documentation (Correct answer)
- Documentation → goal setting → clinical assessment → equipment trial
- Goal setting → documentation → referral review → clinical assessment
Correct answer: Referral review → clinical assessment → goal setting → equipment trial → documentation
A comprehensive mobility evaluation follows the sequence of reviewing the referral, performing clinical assessment, establishing goals, trialing equipment, and then documenting findings.
Question 6: What is the primary clinical significance of measuring seat-to-floor height during a wheelchair evaluation?
- It determines the weight capacity needed
- It affects transfer safety and foot support positioning (Correct answer)
- It establishes the frame material selection
- It defines the armrest style
Correct answer: It affects transfer safety and foot support positioning
Seat-to-floor height directly impacts the safety and ease of transfers and ensures feet are properly supported to prevent shear and pressure at the thighs.
Question 7: A client with Parkinson's disease is being evaluated for a mobility device. Which feature is MOST important to assess for safe manual wheelchair propulsion?
- Cushion foam density
- Tremor severity and upper extremity motor control (Correct answer)
- Backrest height
- Anti-tip wheel placement
Correct answer: Tremor severity and upper extremity motor control
Tremor severity and motor control directly affect a Parkinson's client's ability to safely and consistently propel a manual wheelchair.
CMC Mobility Assessments & Evaluations 3
A CMC is completing a LCDs (Local Coverage Determinations) review for a power wheelchair.
Which criterion is NOT typically required for Medicare power wheelchair coverage?