DME (Durable) & HME (Home) MEDICAL EQUIPMENT
DME is a type of therapeutic equipment that certified physicians prescribe to individuals who are suffering from a certain medical condition or ailment.
DME billing does not cover equipment that is used for convenience or that is beyond a patients legitimate medical necessity.
HME refers to a group of medical devices for patients whose treatment is maintained at home by a nonprofessional caregiver or family member. It is designed to survive frequent usage by non-professionals or patients and it is safe to use at home
DME Objectives –
- Primarily used for medical purposes
- Prescribed or ordered by a medical professional
- Effective to patients only with an injury or disability
- Used repeatedly
- Suitable for usage at home.
DME Equipment’s:
- Ambulatory Aids
- Enteral feeding
- Hospital beds, pressure mattresses, lift beds, blankets
- Medical supplies & incontinence supplies
- Kidney machines
- Mobility aids
- Ostomy & Urological supplies
- Oxygen concentrators, monitors, ventilators
Insurance Coverage for DME :
Medicare – Part A only covers about 80% of the costs associated with DME. Doesn’t cover equipment like hearing aids.
Medicaid – Covers a wide range of DMsupplies than Medicare. Cover a large portion of expenses for qualifying medical supplies.
Commercial – Private insurers often cover a good portion of costs also cover some home safety modifications. They don’t cover disposable materials but they might agree to partially cover some costs.
CPT Codes – DME
The HCPCS codes range Durable Medical Equipment E0100-E8002 is a standardized code set necessary for Medicare and other health insurance providers to provide healthcare claims.
HCPCS Code range (E0100-E8002), Durable Medical Equipment, contains HCPCS codes for Medical equipment, canes of all materials, adjustable or fixed, with tips, Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips, lower leg platform, with or without wheels,Walker, folding (pickup), adjustablePump for alternating pressure pad.
List of CPT codes from AAPC :
E0100-E0159 Walking Aids and Attachments
E0160-E0162 Sitz Bath/Equipment
E0163-E0175 Commode Chair and Supplies
E0181-E0199 Pressure Mattresses, Pads, and Other Supplies
E0200-E0239 Heat, Cold, and Light Therapies
E0240-E0249 Bathing Supplies
E0250-E0373 Hospital Beds and Associated Supplies
E0424-E0487 Oxygen Delivery Systems and Related Supplies
E0500-E0500 Intermittent Positive Pressure Breathing Devices
E0550-E0601 Humidifiers and Nebulizers with Related Equipment
E0602-E0604 Breast Pumps
E0605-E0606 Other Breathing Aids
E0607-E0620 Monitoring Equipment
E0621-E0642 Patient Lifts and Support Systems
E0650-E0676 Pneumatic Compressors and Appliances
E0691-E0694 ULTRAVIOLET LIGHT THERAPY SYSTEMS
E0700-E0710 Safety Devices
E0720-E0770 Stimulation Devices
E0776-E0791 Infusion Pumps and Supplies
E0830-E0948 Traction and Other Orthopedic Devices
E0950-E1036 Wheelchair Accessories
E1037-E1039 Transport Chairs
E1050-E1070 Fully Reclining Wheelchairs
E1083-E1086 Hemi-Wheelchairs
E1087-E1090 Lightweight, High-strength Wheelchairs
E1092-E1093 Heavy Duty, Wide Wheelchairs
E1100-E1110 Semi-reclining Wheelchairs
E1130-E1161 Standard Wheelchairs
E1170-E1200 Amputee Wheelchairs
E1220-E1228 Other Wheelchairs and Accessories
E1229-E1239 Pediatric Wheelchairs
E1240-E1270 Lightweight Wheelchairs
E1280-E1298 Heavy Duty and Special Wheelchairs
E1300-E1310 Whirlpool Baths
E1352-E1406 Accessories for Oxygen Delivery Devices
E1500-E1699 Dialysis Systems and Accessories
E1700-E1702 Jaw Motion Rehabilitation Systems
E1800-E1841 Extension/Flexion Rehabilitation Devices
E1902-E1902 Communication Boards
E2000-E2120 Miscellaneous Pumps and Monitors
E2201-E2295 Manual Wheelchair Accessories
E2300-E2398 Power Wheelchair Accessories
E2402-E2402 Wound Therapy Pumps
E2500-E2599 Speech Generating Devices, Software, and Accessories
E2601-E2625 Wheelchair Seat and Back Cushions
E2626-E2633 Wheelchair Mobile Arm Supports
E8000-E8002 Pediatric Gait Trainers