CERTIFICATE OF MEDICAL NECESSITY QUESTIONS
| NOTE: Questions in this section should be answered accurately to reflect the true condition of the patient. Your answers to specific questions are used by Medicare to establish whether specific items are reimbursable.
Question 1: Patients who require and use a wheelchair to move around in their residence qualify for Medicare reimbursement.
Question 2: Patients who have quadriplegia, fixed hip angle, trunk cast/brace or excessive extensor tone of the trunk muscles qualify for Medicare reimbursement for reclining back feature.
Question 3: Patients who have a cast, brace or musculoskeletal condition, which prevents 90 degree flexion of the knee, or significant edema or the lower extremities that requires an elevating leg rest qualify for Medicare reimbursement for elevating leg rest(s).
Question 4: Patients who have a need for arm height different than that available using non-adjustable arms qualify for Medicare reimbursement for adjustable armrests.
Question 5: Patients who must spend a minimum for two (2) hours per day in the wheelchair qualify for Medicare reimbursement.
Question 6: Patients who have severe weakness of the upper extremities due to a neuralgic, muscular, or cardiopulmonary disease/condition qualify for Medicare reimbursement.
Question 7: If all types of manual wheelchairs have been considered and ruled out, the motorized wheelchair qualifies for Medicare reimbursement.
NOTE: Patients who are non-ambulatory and have severe weakness of the upper extremities due to a muscular or neuralgic disease and/or condition qualify for Medicare reimbursement. Supporting documentation from the physician is recommended.
Information courtesy of Health-E-Quip 
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