If your client is covered by a managed care organization such as: Show
Contact the plan directly for program benefits. Provider guides
Limitation extensionWAC 182-501-0169 allows clients receiving any of these services to request an exception to the limits if their health care needs are not being met. Did you know?You can contact the client's case worker to get assistance with the required documentation. You can do this at any time during the DME authorization process. Patient specific information must be sent via secure email to protect patient privacy and comply with HIPAA regulations. When sending emails, we suggest the following subject lines to help expedite response time.
Resources
Social service authorizations
Durable Medical Equipment (DME) Medicaid Durable Medical Equipment Supplies and Listing, Updates and Training OverviewThe following listing, based upon the Healthcare Common Procedure Coding System (HCPCS), describes equipment and supplies, coverage limitations, and service authorization (SA) requirements. The DME Listing HCPCS codes must be used for all Medicaid claims, regardless of whether Medicare uses the same HCPCS code for the item. Service authorization by Medicaid is not required when Medicare is the primary payer. Reimbursement for Medicare crossover claims will be made in accordance with established Medicare HCPCS codes and guidelines. Appendix BMedicaid Durable Medical Equipment and Supplies and Listing Appendix B 1 Apnea, Respiratory, Oxygen and Vents January 2022 Appendix B 2 Bandages, Dressings, Gauze, and Tape January 2022 Appendix B 3 Bed Pans, Urinals, Incontinence, Catheters, and Irrigation Equip and Supplies January 2022 Appendix B 4 Beds, Mattresses, and Accessories January 2022 Appendix B 5 Burn Garments January 2022 Appendix B 6 Canes, Crutches, and Walkers January 2022 Appendix B 7 Communication Devices January 2022 Appendix B 8 Decubitus and Ulcer Products January 2022 Appendix B 9 Diabetic Products January 2022 Appendix B 10 Dialysis Equipment and Supplies January 2022 Appendix B 11 Dry Heat Application, TENS, NMES January 2022 Appendix B 12 Elastic Support Items January 2022 Appendix B 13 EPSDT Only January 2022 Appendix B 14 Feeding Pumps, Nutritional Supplements, Feeding Kits, and Tubes January 2022 Appendix B 15 I.V. Services Day Rate, Stands, Needles, and Supplies January 2022 Appendix B 16 Miscellaneous Durable and Expendable Supplies January 2022 Appendix B 17 Orthotics January 2022 Appendix B 18 Ostomy and Colostomy Pouches January 2022 Appendix B 19 Traction Equipment January 2022 Appendix B 20 Wheelchairs and Accessories January 2022 Appendix B 21 Excel Version with all Categories of Appendix B January 2022
Training Durable Medical Equipment What is an example of durable medical equipment?Equipment and supplies ordered by a health care provider for everyday or extended use. Coverage for DME may include: oxygen equipment, wheelchairs, crutches or blood testing strips for diabetics.
What medical equipment is not covered by Medicare?This includes stairway elevators, grab bars, air conditioners, and bathtub and toilet seats. Items that get thrown away after use or that are not used with equipment. For example, Medicare does not cover incontinence pads, catheters, surgical facemasks, or compression leggings.
Are bandages considered durable medical equipment?What Is Considered Durable Medical Equipment? Durable medical equipment includes medical devices and supplies that can be used again and again, such as a hospital bed in your home or a prosthetic limb. The opposite of DME would be single-use medical equipment like bandages or incontinence pads.
Does Medicare Part A cover 80 of the cost durable medical equipment?If you own Medicare-covered DME and other devices, Medicare may also cover repairs and replacement parts. Medicare will pay 80% of the Medicare-approved amount (up to the cost of replacing the item) for repairs. You pay the other 20%. Your costs may be higher if the supplier doesn't accept assignment.
Is a knee brace considered DME?Orthotic devices like braces are otherwise known as Durable Medical Equipment. Braces may be used to support the knee, neck, arm, or back. Combining the use of orthotic devices with other treatments may delay the need for a surgical procedure.
Does NC Medicaid cover DME?Durable Medical Equipment (DME) is covered under NC Medicaid Managed Care for beneficiaries enrolled in a managed care plan and under NC Medicaid Direct for those beneficiaries who remain in NC Medicaid Direct. DME is NOT carved out of managed care.
|
List of durable medical equipment covered by medicaid
Related Posts
Copyright © 2024 ihoctot Inc.
