Please note that this criteria is taken and summarized directly from Noridian Medicare's LCD page. We try to keep this updated as possible. For the full article, please click here.
Walker with no wheels / Front-Wheeled Walker
• The patient has a mobility limitation that significantly impairs his/her ability to participate in one of more Mobility-Related Activities of Daily Living (MRADL’s) within the home including . . .
• One of the following 3 statements must be stated in the clinical notes
The mobility limitation prevents the patient from accomplishing the MRADL entirely, or
The mobility limitation places the patient at reasonably determined heightened risk of morbidity or mortality
secondary to the attempts to perform the MRADL, or
The mobility limitation prevents the beneficiary from completing the MRADL within a reasonable timeframe.
• The functional mobility deficit can be sufficiently resolved by use of a walker or (walker with wheels).
Heavy Duty Walker / Heavy Duty Front-Wheeled Walker• Must meet all the criteria above; and
• The patient's weight is over 300lbs. (Height and weight must be listed on RX)
Walker with Wheels and Seat Attachment• Must meet all the criteria listed under walker with no wheels; and
• The clinical notes must state that the patient must frequently stop and sit to rest while ambulating
Questions to ask patients• Have you fallen recently? If so, where and how often?
• Why do you require this equipment?
• If it is for a rollator . . . Can they squeeze using their hands?
If they are unable to, it most likely is not safe for them to use a walker with wheels and seat.