I've paid out of pocket for 2 Lashers, a Marvel, and an Icon. I'm finally gonna use Medicare to get a new chair. Marvel is sold, Icon to be sold shortly, and one of my Lashers is giving me fits on account of needing a higher back due to an injury. So, I'm replacing it.

I had my seating eval today. The OT was fantastic. Very knowledgeable about seating, fitting, available chairs on the market and such. There was a DME rep there too. Both really nice guys, but not up to snuff on Medicare billing and reimbursement limits, at all.

I kept trying to stay focused on the K0005 ultra-lights but they kept driving me to spec out exactly what I wanted and let them deal with reimbursement and such. The OT had a great letter he claims works every time for an ultra-light and the DME kept insisting his billing person gets titanium ZRs and TRs funded via Medicare. Needless to say, I was (and am) super skeptical. I referred them to the Local Coverage Determination, the 'titanium isn't medically necessary' CMS publication, and the 'you can't unbundle titanium as an option' CMS publication, but they shrugged them off and said it won't be a problem.

I said, 'Whatever, it's your time (and money) that's gonna be wasted, not mine."

So, we shall see. I'm fully expecting to get a call from the DME with a complete rejection of everything we spec'd out (My ideal ZR), despite their reassurances. They seemed to want to believe they knew more about this process than me, which, is always possible. I guess. Having been in the Medicare/caid actuary field for nearly a decade, and through this process vicariously over and over and over again around here, I kinda doubt it.

I've already got the order form filled out, ready to hand to him, for an appropriate (and my preferred) K0005 chair to my specifications (Top End Crossfire T6).

This should be a fun ride. I will shit a literal brick of they pull it off, but I'm calling it now: no fucking way!