CSHCN 2008 > Durable Medical Equipment (DME) > Adaptive Strollers

14.4 Adaptive Strollers

Adaptive strollers may be noncustom DME, or they may be custom DME if they are in any way customized to the individual client's needs.

Adaptive strollers are mobility devices that resemble regular strollers purchased for healthy infants and toddlers. Adaptive strollers have a limited range of accessories that allow some positioning for clients with minor postural problems. Adaptive strollers may be authorized only when medically necessary and when all of the following conditions are met:

•The stroller has a firm back and seat, or insert.

•A stroller (rather than a wheelchair) is specifically recommended by the licensed therapist completing the wheelchair evaluation.

•The requested stroller meets all recommendations made in the wheelchair evaluation.

•The client is not expected to develop motor skills necessary for self-propulsion and is not expected to need a travel chair or wheelchair within two years of the request date, or the client is expected to be ambulatory within one year of the request date.

Requests for clients older than two years of age must meet the above criteria, and there must be medical documentation of the need for a stroller versus a wheelchair. Medical documentation should indicate that a stroller allows adequate support for a client's particular condition, stature, and need for positioning (completion of the CSHCN Services Program Wheelchair Seating Evaluation Form serves as medical documentation).

The following criteria must be met for the level of stroller requested:

•Level 1: Basic stroller. The client meets the criteria for a stroller.

•Level 2: Stroller with tray for oxygen and/or ventilator. The client meets the criteria for a Level 1 stroller and is oxygen- or ventilator-dependent.

•Level 3: Stroller with positioning inserts. The client meets the criteria for a Level 1 or Level 2 stroller and requires additional positioning support.

Providers should use the following procedure codes and modifiers to submit claims for strollers. Levels 2 and 3 require the addition of a modifier: