Description: The patient must
be incapable of performing routine activities without the DME
What is a DurableMedical
Equipment?
Introduction
Any
medical equipment used in the home in order to help in a better quality of
living can be called as durable medical equipment (DME). This includes iron
lungs, oxygen tents,power scooters, Nebulizers, catheters, hospital beds,
wheelchairs, walkers, and portable oxygen equipment.
Characteristic Features of a Durable Medical Equipment
An
equipment is called as a DME, if
·
It
is primarily used for medical purposes
and is meant to be used for medical purposes
·
If
it can be subject to repeated use
·
In
the absence of a medical condition, this equipment is of no use to the person
·
It
is designed to be used in and around the home
DMEPOS
Certain
insurances cover prosthetics, orthotics and certain other supplies, which are
collectively denoted as POS, under durable medical equipment. These are devices
that can replace missing body part, and support or correct any bodily
malfunction.
Equipmentthat are Not Durable Medical Type
·
Items
that are use-and-throw are not durable medical equipment; some examples are
surgical face masks, incontinence pads and leggings.
·
Items
that are not appropriate to be used at home, such as paraffin bath units and
oscillating beds.
·
Items
that need to be used under medical supervision or under medical institutional
settings
·
Items
that are not intended to be used in the home but are primarily used outside the
home.
·
Items
used for convenience rather than medical need.
Some examples are stairway elevators, bathtub and toilet seats.
Qualifying for a DME
Any
person can purchase durable medical equipment on a prescription from his
treating physician. For one to qualify for a DME reimbursed by his or her
insurance the following criteria need to be met:
1. The equipment must be a medical
need for a normal living.
2. It must meet the definition of
durable medical equipment.
3. The physician must justify that
the DME is a requirement to safety and effectively treat the patient.
4. The patient must be incapable
of performing routine activities without the DME
5. The physician must prove that
the absence of the DME significantly hampers the patient’s normal living.
6. The patient must be able to
operate, or use the equipment without any assistance.
7. The equipment must be safe
enough to be used in a home environment.
Exceptions
Some
insurance companies cover certain disposable items as a part of durable medical
equipment reimbursement if they can significantly lower the risks associated
with the medical condition and or if they are important preventive care
measures. Some examples are nondurable items such as lancets and test strips
used for glucose testing in diabetics.
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