New Codes for Power Mobility Devices Effective October 1

The Centers for Medicare and Medicaid Services (CMS), Baltimore, has made significant progress in the area of power mobility devices (PMDs) in order to ensure that Medicare beneficiaries have access to the appropriate vehicles to meet their needs. CMS' recent regulations on PMDs implement important provisions of the Medicare Modernization Act of 2003 designed to streamline and ensure appropriate access for Medicare beneficiaries to mobility technology. The new codes for PMDs are effective on October 1, 2006.

The current codes for power wheelchairs have been in use since 1993, and the one code for power operated vehicles has been in use since 1986. Subsequent innovations in the PMD field have created a need to expand both the number of categories and the number of codes. Through ongoing collaboration with the industry, CMS has made great strides in developing new codes and product-testing standards to ensure that Medicare beneficiaries have access to the appropriate vehicles to meet their needs.

"I think the codes are good for the industry in the respect that they have clearly isolated the intended use and the target market for whom they're considered," says Cody Verrett, ATS, director of clinical and educational development at Quantum Rehab, a division of Pride Mobility. "For example, a K11 today could be anything from a very low-end retail light-duty power chair intended for somebody with just a mobility need. That allowable is the same as would be paid out for somebody who is recovering from an advanced spinal cord injury. Those two populations could be very, very different in ultimate need. So I do think that it's going to help."

The revised codes are the product of extensive discussions with the industry and other experts in the field and closely mirror the recommendations of a technical expert panel (TEP) that was convened in February 2006. The 14-member TEP was comprised of suppliers, manufacturers, testing facilities, rehabilitation engineers, and clinicians.

Under the new codes, there will be six groups of power mobility devices with a total of 64 codes that separate PMDs based on device functionality and levels of performance. The 64 codes include not only the type of power wheelchair "base" but also the options and accessories that come standard with these devices.

"They have set the codes up that show a true progression of need, where it's light duty, general purpose, more of an advanced, and then your outdoor or more active user codes," Verrett says. "Basically, the way they've laid them out is helpful in respect to identifying and clearly allowing more products to fit in different allowable codes, but those codes would be specific to consumer need, and that's really what we hope the codes will do: Clearly say this is the appropriate chair for that gentleman with the spinal cord injury so that he doesn't end up in that chair at the lower end of the spectrum that he's not most appropriate for."

Editor's Note: Here is a complete list of the new CMS codes affecting power mobility devices.

Altimate Medical Awarded for Workplace Safety and Health

Altimate Medical, Morton, Minn, was recently awarded a 2006 Meritorious Achievement Award for excellence in workplace safety and health. This is the sixth safety award that Altimate Medical has received since 1998.

In May, Altimate Medical was one of 191 employers (out of 447 entrants) who were recognized at the awards luncheon in Minneapolis. Altogether, 87 companies were given the Meritorious Achievement Award.

"Smart employers like Altimate Medical understand that a commitment to safety contributes to the health of their employees and their bottom line," says Carol Bufton, president of the Minnesota Safety Council.

Partnership Anticipates Broadening of CE Services

Motivations Inc, Fort Mill, SC, and Dynamic Learning Online Inc, Oldsmar, Fla, announce a partnership in continuing education services. By combining their resources, the companies can span the CEU continuum of live seminars and online courses for medical rehabilitation personnel.

Motivations Inc began in 1999 furnishing CEU level courses, and currently operates in 30 states with hands-on learning. Dynamic Learning Online Inc, also founded in 1999, has one of the most comprehensive collections of online courses available for rehabilitation personnel and offers its instruction in an easy to access format.

"It was a natural partnership where our companies complement each other's services while offering a fuller array of options to each of our client bases," says Jane Boston, president of Motivations Inc.

"With both companies bringing their expertise in continuing education offerings to the table, we can provide our students with the most comprehensive selection of both live and online seminars to satisfy every learning style," says Melissa Cohn, president of Dynamic Learning Online Inc.

Both companies carry national credentials as CEU-approved providers through ASHA, AOTA, and the International Association for Continuing Education and Training, and work with licensing boards as appropriate for the course topics. Collectively, these two companies represent more than 50 national instructors and courses available to individuals, facilities, and national level employers.

Rehab Management to Launch Weekly E-Newsletter

October 2 marks the launch of Rehab Today, a free weekly e-newsletter for the physical medicine community.

Produced by the Rehab Management team, Rehab Today will provide timely, in-depth coverage of topics affecting the rehabilitation industry, including facility news, product releases, and government issues.

Sign up here to receive this free weekly e-newsletter.

Team Designs Program To Help Elderly Perform Daily Tasks

A Thomas Jefferson University team has found that a personalized program of occupational and physical therapy—plus modifications in the home—can go a long way to help elderly individuals continue to live independently and also live longer.

Laura Gitlin, PhD, director of the Center for Applied Research on Aging and Health at Thomas Jefferson University in Philadelphia, and her team reported previously that a brief six-visit program consisting of physical therapy, occupational therapy, home modification, and some instruction in problem-solving helped elderly individuals in performing daily activities. After 6 months, those of the 319 men and women ages 70 and older enrolled in the study who received the intervention had fewer difficulties with daily living tasks, especially personal care activities such as bathing and going to the toilet, than those who did not receive the help. Intervention participants were less afraid of falling, had more confidence in their abilities to manage everyday activities, and used more effective coping strategies.

In a 14-month follow-up study, Gitlin, who is professor of occupational therapy at the College of Health Professions of Thomas Jefferson University, and her co-workers report in the July issue of the Journal of the American Geriatrics Society that the efforts had an even larger benefit.

They found that 1% of those receiving the intervention had died, compared to 10% in the control group. During the same 14-month period, of 31 participants who had been previously hospitalized and who received the intervention, none died. In contrast, in the control group, 21% who had been hospitalized died.

"These results appear to confirm that we are helping people address functional difficulties that in turn offsets further decline," Gitlin says. "As people age, they often confront difficulties in carrying out everyday activities due to age-related changes and chronic diseases, which can have significant functional consequences. Chronic conditions such as heart disease, stroke, arthritis, and diabetes often result in older people having problems with daily tasks such as bathing, dressing, and preparing meals."

"It may become harder to get out of a chair or get dressed," she says. "When you begin to have functional difficulties, it is very much associated with fear of falling. We were interested in affecting how people thought and solved their daily functional problems, helping build their confidence by introducing effective coping strategies, making homes safer, and improving performance."

The 6-month intervention consisted of five "contacts" by an occupational therapist (four 90-minute visits and one phone call) and one physical therapy visit for 90 minutes.

New Iontophoretic Drug Delivery Company Introduces Trivarion

ActivaTek Inc is a new and innovative iontophoretic drug delivery company based in Salt Lake City and formed by Jamal Yanaki, the company's president and CEO. Yanaki has more than 17 years of experience in developing and marketing medical device products for medical professionals and end users.

"ActivaTek Inc prides itself on high-quality products, safety, and effectiveness that provide the best value to its customers," Yanaki says. "ActivaTek Inc is focused on the rehabilitation market and will continue to introduce new and innovative products to service the market and enhance patient care."

The emphasis on safety was a precondition to the founding of ActivaTek Inc. The company will not make products that do not exceed industry standards for safety, as well as efficacy, he says.

The Food and Drug Administration (FDA) approved the Trivarion system on August 1, 2006, to deliver noninvasive ionic medicament through the skin. The Trivarion drug delivery electrodes are compatible with FDA-cleared constant current iontophoresis.

The following topics were included in ActivaTek's formal risk assessment and risk management that governed the design evolution of the Trivarion iontophoresis electrode system. Safety was designed into the Trivarion electrodes: moderating pH shifts due to hydrolysis; avoiding internal high current densities; and electrode conformability to various treatment sites.

Yanaki says there are several factors that make Trivarion a unique iontophoresis system:

• Its shape easily conforms to numerous anatomical treatment sites.
• Precise and maximum strength with a pH buffering capacity up to 80 mA min.
• Large surface areas for the active and ground electrodes.
• Low impedance and a highly absorbent drug matrix.
• Flexibility. Trivarion contours perfectly to difficult adhesion areas such as knuckles, fingers, feet, etc.

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