Insurance Coverage Procedures for Adiant Mobile Personal Emergency GPS Safety Device

Insurance Coverage Procedures for Adiant Mobile Personal Emergency GPS Safety Device

We always recommend contacting your primary insurance company or state Medicaid Program office to find out exactly what they cover and what documentation they require. This is just a basic outline of what is typically required.

1)Using the list of codes provided, obtain a prescription from thedoctor.

2)Request a quote directly from Adiant Mobile or one of its authorized distributors.

3)Submit prescription and quote to either your case/ social worker or directly to your insurance company to make sure they will cover the Adiant Mobile device and associated servicefee.

***For individuals enrolled in Medicaid waiver programs, please contact us at 800 939 3952 to see if we are already on their authorized durable medical equipment provider list.

If you have any general questions, please send an email to or go to the contact page at

Please remember we are unable to bill Medicaid or your private insurance directly and therefore you are responsible for payment and submission of the paperwork required for reimbursement.

If you have any specific questions, please contact our Customer Service Dept. at 877-980-4477 or email at

Private Insurance or Medicaid Reimbursement Insurance Instructions

Insurance Codes for Adiant Mobile MX-LOCare GPS Watch

These devices are confirmed to be covered by: Kaiser Permanente, United Healthcare, Transatlantic Insurance, American Maritime Officers, and Select Health to name a few.

The concept of wandering was added to ICD-9CM effective with the October 1, 2000 update as an inclusion term under at code 294.11

Prescription from Doctor: A prescription from your Physician needs to be requested and including the following information:

Name: Adiant Mobile MX-LOCare GPS Watch for Wandering Prevention

Diagnoses Code

Alzheimer’s Disease (331.0)

Autism or Pervasive Development Disorder PDD (299.0-299.9)

Dementia, unspecified, with behavioral disturbance (294.21)

Intellectual disabilities (317-319)

Sub code: (See above) Wandering Code: V40.31

HCPCs: S5162 - Billing Code for Purchase

Submit this to the insurance company or state funded program with a receipt for your purchase.

Additional Codes (if needed)

Other: If denied – Use Enhanced Medical Assistive technology

HCPCs: S5199

CPT Codes – X is HIPAA compliant code S is CPT or HCPCs code

X5012 Personal emergency response system S5160, S5161, S5162

(cont’d)

S5160: Emergency response system; installation andtesting S5161:

Emergency response system; service fee, per month (Excludes installation andtesting)

S5162: Emergency response system; purchase only X5014 DME – personal emergency response system, Installation

The new HCPCs codes level 2 are for items not covered in level 1 coding. Try these new codes HSW is Health, Safety, & Welfare

HCPCs Code - S5160K

Units of Service – Maximum allowed based on 12 month plan

Personal Emergency Response System – install/test (HSW Only)

HCPCs Code – S5161HK Per Month

Unit of Event Personal Emergency Response System - monthly service fee (HSW only)S5161HK PerMonth

HCPCs 2017 Code – E1399 Durable Medical Equipment, miscellaneous

Please feel free to contact us is you have any questions or feel you require further assistance.

Private Insurance or Medicaid Reimbursement Insurance Instructions

Private Insurance or Medicaid Reimbursement Insurance Instructions