Writing a Letter of Medical Necessity for a Wheelchair

Writing a Letter of Medical Necessity for a Wheelchair Susan Christie, PT, ATP June 2015 2 Objectives Identify 5 components of a Letter of Medical Necessity Explain the Medicare algorithm for MAE (Mobility-assistive Equipment) Give 3 examples of MRADLs (Mobility-related Activities of Daily Living 3 Purpose of the LMN Documents the Medical need for the recommended equipment Allows the payer to understand the needs and authorize the equipment Provides specs for the Wheelchair checkout at delivery 4 Persons involved Client Caregivers Therapist Supplier (ATP) Physician (sometimes on-site) 5 Client Gives an accurate history Indicates his/her needs and desires Participates in discussion of components and strategies 6 Therapist Performs a comprehensive evaluation Documents the evaluation and Wheelchair specs Justifies each component of the chair Follows up as needed 7 Supplier Checks same or similar equipment Provides order forms and information Participates in the selection of the equipment Educates the physician about MC rules Obtains physician signatures 8 The Evaluation includes: Detailed history Neuromuscular status Sensation Pain Functional status 9 The Evaluation Social/living situation Mobility needs and recommendations Seating and positioning needs and recommendations 10 Mobility limitation or deficit Something that prevents the consumer from accomplishing)

Dependent lower extremity edema. She uses a BiPap at night and part-time during the day. She is 5’6”, 106 pounds, BMI 17.1, ... -Flat-free inserts in tires as she cannot fill air tires ... risk of pressure ulcers because of her low body weight, inability to …

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  Medical, Letter, Free, Necessity, Extremity, Weight, Wheelchairs, Letter of medical necessity for a wheelchair

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