MedicaidPrior AuthHigh impact
New Prior Approval and Claim Coding Instructions for All Wheelchair and Power-Operated Vehicle (POV) Repairs and Modifications Effective May 1, 2014
Illinois Medicaid - HFS·IL · PM&R (Physical Medicine & Rehab), Occupational Therapy, Physical Therapy·Provider Notice
Effective date
May 1, 2014
We identified it
Jun 20, 2026
Summary
Starting May 1, 2014, all wheelchair and power-operated vehicle (POV) repairs exceeding $400 require prior approval, with new specific coding requirements for both paper and electronic claims. Providers must use designated Purchase/Rental codes and modifiers when submitting claims for wheelchair repairs and modifications.
Action Required
By May 1, 2014: DME billing team must update systems to require prior authorization for all wheelchair and POV repairs exceeding $400. Update paper HFS 2210 forms to use Purchase/Rental codes (1=Purchase, 2=Rental, 3=Repair, 4=Modification, 5=Loaner) and enter last 8 digits of prior approval numbers. For electronic 837P claims, use all 10 digits of prior approval number and update modifiers (NU=Purchase, RR=Rental, RB=Repair, KA=Modification). Complete HFS 1409 Prior Approval Request forms with appropriate Pur/Rent codes (P, R, M, F). Claims without proper prior approval and coding will be rejected.