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ROLLATORS

Coverage Guidelines

A standard walker and related accessories are covered if all of the following criteria (1-3) are met:

1.   The beneficiary has a mobility limitation that significantly impairs his/her ability to participate in one or more mobility-related activities of daily living (MRADL) in the home. 

A mobility limitation is one that:

  • Prevents the beneficiary from accomplishing the MRADL entirely, or

  • Places the beneficiary at reasonably determined heightened risk of morbidity or mortality secondary to the attempts to perform the MRADL, or

  • Prevents the beneficiary from completing the MRADL within a reasonable time frame; and

2.   The beneficiary is able to safely use the walker; and

3.   The functional mobility deficit can be sufficiently resolved with use of a walker.

** If all of the criteria are not met, the walker will be denied as not reasonable and necessary.


ROLLATORS COVERAGE GUIDELINES


A heavy duty, multiple braking system, variable wheel resistance walker (E0147) is covered for beneficiaries who meet coverage criteria for a standard walker and who are unable to use a standard walker due to a severe neurologic disorder or other condition causing the restricted use of one hand. Obesity, by itself, is not a sufficient reason for an E0147 walker. If an E0147 walker is provided and if the additional coverage criteria are not met, it will be denied as not reasonable and necessary.

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