Walker documentation needs

The following qualification criteria need to be documented in the patients’ medical record notes to qualify for the prescribed equipment. Note: Justification notes are valid for six months.

Standard walker: All of the following need to be sufficiently documented to support the need for the prescribed equipment.

  • Explain the patient’s mobility limitation that significantly impairs (HIS or Her) ability to participate in one or more mobility-related activities of daily living (MRADL) in the home.
  • Explain why the patient is able to safely use a walker.
  • Explain how the patient’s functional mobility deficit will be sufficiently resolved by the use of a walker.

Heavy Duty walker, document the above information and the following.

  • Document the patient’s weight. Note: the patient must weigh 300lbs or more to qualify.

Seat for a walker, document the above information and the following

  • Explain why the patient needs a seat for a walker.
    • Example: The patient cannot ambulate from room to room without resting

Standard walker accessories

  • Explain why the patient needs the accessory.

Diagnosis: See LCD (Local coverage determination) at CGSMedicare.com for any additional qualifying information questions, diagnosis codes and descriptions

Medicare approved detailed equipment descriptions for walkers and attachments

Walker – folding, adjustable youth (4’4″-5’7″), (HCPC) E0135
Walker -folding, adjustable, adult (5’4″-6’6″), (HCPC) E0135
Walker heavy duty folding, without wheels, weight over 300 lbs., (HCPC) E0148
Walker – folding, wheeled, adjustable youth (4’4″-5’7″), (HCPC) E0143
Walker -folding, wheeled, adjustable, adult (5’4″-6’6″), (HCPC) E0143
Walker heavy duty folding, wheeled, weight over 300 lbs. , (HCPC) E0148
Seat attachment for walker, (HCPC) E0156
Walker, folding, adjustable, Hemi (side stepper) , (HCPC) E0135
Platform attachment for walker, (HCPC) E0154
Wheel attachment for walker, (HCPC) E0155

Patient notes/justification – Must be documented using your normal dictation process. Letter of medical necessity, notes wrote on letterhead or prescriptions are not valid.

Prescription/order requirements– Must contain Patient’s name, date of the order and Start date, detailed equipment description (See above), signature of the ordering physician and a signature date.

10/17