|Wheelchairs (Manual and Power Operated) "Notification"
||Under the When Covered section, Item III. Criteria for Specific Types of Power Wheechairs (PWC): item #1. Group 1 PWC - removed item c. as follows; “ The wheelchair is provided by a supplier that employs a RESNA-certified Assistive Technology Professional (ATP) who specializes in wheelchairs and who has direct, in-person involvement in the wheelchair selection for the member.” Under the When Not Covered section, added item #4 as follows: “ Items used to support activities of daily living (ADLs) that do not address a mobility limitation such as robotic arms (e.g. KINOVA JACO® assistive arm) are considered not medically necessary. Items used for assistance with ADLs are considered to be self-help or convenience items that are not primarily medical in nature. Custodial or self-help care is not covered.” Table 1 under Policy Guidelines updated with addition of KINOVA JACO assistive robotic arm along with associated indications. Policy noticed 11/30/21 with effective date of 1/25/22. Medical Director review. 11/2021.