The biggest issue I have with that is they're saying K0005 covers all frame materials yet they deny claims for specifically for being titanium. This is because the manufacturers have changed titanium from a discreet product to an "upgrade option" on aluminum frames. Medicare denies the upgrade, on the grounds it's baked into the base code, but manufacturers have hence refused to not classify it an "optional upgrade". Because they want more money for it.

If they'd remove that as an "option", just make it a different product, the way it used to be, the Medicare logic of "all frames are included in K0005" would work fine. That won't happen though, because the reimbursement isn't high enough to make it worth their while.

So, there is a problem on both the payer and the manufacturer sides of this equation. Moving titanium to an option was a business decision and has as much to do with why we don't have access to it as the way Medicare decided to classify titanium frames. For the manufacturer quoted in that article to insinuate it's all Medicare screwing us over is a bit disingenuous. The manufacturers could solve this for us, too, but they're protecting their margins. Medicare is doing the same thing, protecting their medical loss ratios.

Neither side is doing what's best for our needs, frankly.