SMS Funding and Documentation

Question 1

Under Medicare, which category covers manual and power wheelchairs as Durable Medical Equipment?

Accepted Answer

Part B

Answer

Medicare Part B covers Durable Medical Equipment, including manual and power wheelchairs, when medically necessary.

Question 2

What is a Letter of Medical Necessity (LMN) in the context of seating and mobility funding?

Accepted Answer

A clinician-authored document that explains why a specific device is medically required for the patient

Answer

An LMN is written by the prescribing clinician or therapist detailing the patient's diagnosis, functional limitations, and clinical justification for the specific device requested.

Question 3

Which of the following is required documentation for Medicare to cover a power wheelchair?

Accepted Answer

A face-to-face examination by the treating physician or NPP within 6 months prior to the written order

Answer

Medicare requires a face-to-face examination by the treating physician or non-physician practitioner (NPP) within 6 months before the written order for a power wheelchair.

Question 4

The term 'prior authorization' in wheelchair funding refers to:

Accepted Answer

Payer approval obtained before the device is provided, to confirm coverage

Answer

Prior authorization is a process where the payer reviews clinical documentation and approves coverage before the device is ordered and delivered.

Question 5

A 'K-level' classification in lower extremity prosthetics is analogous to which concept in wheelchair funding?

Accepted Answer

Functional level matching device capability to patient ability

Answer

K-levels classify functional ability to match prosthetic components to patient capability, similar to how wheelchair complexity codes are matched to functional mobility levels.

SMS - Certified Seating and Mobility Specialist Practice Test

SMS - Certified Seating and Mobility Specialist Practice Test

SMS Funding and Documentation