This section covers a wide variety of medical and surgical supplies, as well as some DME-related supplies and accessories. Medicare generally covers DME-related supplies, accessories, maintenance, and repair under the prosthetic devices provision.
Supra sdrm, per square centimeter
Suprathel, per square centimeter
Innovamatrix fs, per square centimeter
Skin substitute, fda cleared as a device, not otherwise specified
Syringe with needle, sterile, 1 cc or less, each
Syringe with needle, sterile 2 cc, each
Syringe with needle, sterile 3 cc, each
Syringe with needle, sterile 5 cc or greater, each
Needle-free injection device, each
Supplies for self-administered injections
Continued
Non-coring needle or stylet with or without catheter
Syringe, sterile, 20 cc or greater, each
Needle, sterile, any size, each
Sterile water, saline and/or dextrose, diluent/flush, 10 ml
Sterile water/saline, 500 ml
Sterile saline or water, metered dose dispenser, 10 ml
Refill kit for implantable infusion pump
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately)
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately)
Supplies for maintenance of insulin infusion catheter, per week
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each
Supplies for maintenance of insulin infusion pump with dosage rate adjustment using therapeutic continuous glucose sensing, per week
Infusion set for external insulin pump, non needle cannula type
Infusion set for external insulin pump, needle type
Syringe with needle for external insulin pump, sterile, 3 cc
Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each
Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each
Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each
Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each
Continued
Supply allowance for adjunctive continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service
Alcohol or peroxide, per pint
Alcohol wipes, per box
Betadine or phisohex solution, per pint
Betadine or iodine swabs/wipes, per box
Chlorhexidine containing antiseptic, 1 ml
Urine test or reagent strips or tablets (100 tablets or strips)
Blood ketone test or reagent strip, each
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips
Platforms for home blood glucose monitor, 50 per box
Normal, low and high calibrator solution / chips
Replacement lens shield cartridge for use with laser skin piercing device, each
Spring-powered device for lancet, each
Lancets, per box of 100
Cervical cap for contraceptive use
Temporary, absorbable lacrimal duct implant, each
Permanent, long term, non-dissolvable lacrimal duct implant, each
Permanent implantable contraceptive intratubal occlusion device(s) and delivery system
Paraffin, per pound
Diaphragm for contraceptive use