In simple words: This code covers a heavy-duty electric scooter for people weighing 451-600 lbs who have difficulty moving around on their own and can't use a manual wheelchair.

This code covers the supply of a group 2 power operated vehicle (POV) for patients who cannot achieve independent movement with devices such as canes, walkers, or manual wheelchairs. This specific code is used for a very heavy-duty POV with a patient weight capacity of 451 to 600 pounds. POVs (also known as scooters) are medically necessary DME for patients with impaired ability to carry out activities of daily living (ADLs) such as using the toilet, eating, dressing, grooming, and bathing in customary locations in the home, and whose upper extremity strength is too limited to propel a manual wheelchair.A POV is a battery-operated scooter with three or four wheels, prescribed to patients who have sufficient ability to safely operate and control the vehicle.

Example 1: A 500-lb patient with severe osteoarthritis in both knees, limiting their mobility within their home, requires a heavy-duty scooter for basic ADLs., A patient post-stroke with significant lower extremity weakness and a weight of 480 lbs requires a POV to maintain independence in their home environment., A 550-lb patient with morbid obesity and limited mobility due to shortness of breath needs a very heavy-duty POV to navigate their home and perform essential daily tasks.

Documentation should include the patient's weight, the medical reason for requiring a POV (impaired mobility, limitations in ADLs), assessment of the patient's ability to safely operate the device, and the specific type of POV prescribed (group 2 very heavy duty).Prior authorization documentation may also be required.

** Prior authorization may be required.The G9156 code may be billed for the face-to-face evaluation for wheelchair requirements.