Showing Medical Necessity When Ordering Your Client a Wheelchair

Ordering a Wheelchair

When obtaining a wheelchair for your client, there are a few important items that are necessary to include in your note:

• Face to face exam
  • To document this: client was evaluated for mobility needs
• What causes mobility limitations
  • To document this: Client has mobility issues secondary to diagnosis of COPD, CHF and hip and knee osteoarthritis
• What activities of daily living our compromised - document: Diagnosis prevent client from going from her room to the dining room to eat and to the bathroom to toilet
• Is client capable of self propelling and is she willing to use wheelchair. Determining factor is UE strength which needs to be MMT > ⅗ - document: Client has UE strength of ⅘ and is able to and willing to self propel a wheelchair
• What activities will be resolved using wheelchair (ex eating, bathing, toileting, grooming, dressing)
  • To document this: Use of wheelchair will allow client to go from bedroom to kitchen to eat and to bathroom to toilet.
• Was a cane and walker ruled out
  • To document this: Client unable to ambulate from bedroom to dining room with cane or walker.
• How many hours per day will client be using the wheelchair 
  • To document this: Client will use chair at least 3 or more hours per day. Seat cushion in ordered to prevent skin breakdown.
• Will client transfer from wheelchair to bed
• To document this: Removable armrests are required for transfers. This cannot be accommodated with non-adjustable armrests

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