To get insurance coverage for Custom Ultralight Manual Wheelchairs (K0005), your insurance provider must determine you have a "medical necessity" for the equipment. This means you must have a condition that requires the equipment to prevent, diagnose, or treat and illness or injury; such as, you are unable to accomplish daily living activities in a safe and timely manner in your home without the aid of a Custom Ultralight Manual Wheelchair. This includes ruling out ambulating unassisted, using a cane or walker, inability to self-propel in any other manual wheelchair (K0001 - K0004), and the individual must be suffering from paraplegia, higher-level quadriplegia, hemiplegia, multiple sclerosis, brain injury or those with developmental disorders such as cerebral palsy, spina bifida and muscular dystrophy can maximize their independence with the use of a K0005 mobility base. The important piece is the client’s functional potential and the long-term goals that have been determined in therapy. If the client has the motivation and the functional capacity to self propel, an ultralight is appropriate.

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