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.
Replacement pad for use with medically necessary alternating pressure pad owned by patient
Radiopharmaceutical, diagnostic, not otherwise classified
Indium in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries
Tissue marker, implantable, any type, each
Surgical supply; miscellaneous
Implantable radiation dosimeter, each
Calibrated microcapillary tube, each
Microcapillary tube sealant
Peritoneal dialysis catheter anchoring device, belt, each
Syringe, with or without needle, each
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Sphygmomanometer/blood pressure apparatus with cuff and stethoscope
Blood pressure cuff only
Automatic blood pressure monitor
Disposable cycler set used with cycler dialysis machine, each
Drainage extension line, sterile, for dialysis, each
Extension line with easy lock connectors, used with dialysis
Chemicals/antiseptics solution used to clean/sterilize dialysis equipment, per 8 oz
Activated carbon filter for hemodialysis, each
Dialyzer (artificial kidneys), all types, all sizes, for hemodialysis, each
Bicarbonate concentrate, solution, for hemodialysis, per gallon
Bicarbonate concentrate, powder, for hemodialysis, per packet
Acetate concentrate solution, for hemodialysis, per gallon
Acid concentrate, solution, for hemodialysis, per gallon
Treated water (deionized, distilled, or reverse osmosis) for peritoneal dialysis, per gallon
"y set" tubing for peritoneal dialysis
Dialysate solution, any concentration of dextrose, fluid volume greater than 249 cc, but less than or equal to 999 cc, for peritoneal dialysis
Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis
Dialysate solution, any concentration of dextrose, fluid volume greater than 1999 cc but less than or equal to 2999 cc, for peritoneal dialysis
Dialysate solution, any concentration of dextrose, fluid volume greater than 2999 cc but less than or equal to 3999 cc, for peritoneal dialysis
Dialysate solution, any concentration of dextrose, fluid volume greater than 3999 cc but less than or equal to 4999 cc, for peritoneal dialysis
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Dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc but less than or equal to 5999 cc, for peritoneal dialysis
Dialysate solution, any concentration of dextrose, fluid volume greater than 5999 cc, for peritoneal dialysis
Dialysate solution, non-dextrose containing, 500 ml
Fistula cannulation set for hemodialysis, each
Topical anesthetic, for dialysis, per gram
Injectable anesthetic, for dialysis, per 10 ml
Shunt accessory, for hemodialysis, any type, each
Blood tubing, arterial or venous, for hemodialysis, each
Blood tubing, arterial and venous combined, for hemodialysis, each
Dialysate solution test kit, for peritoneal dialysis, any type, each
Dialysate concentrate, powder, additive for peritoneal dialysis, per packet
Dialysate concentrate, solution, additive for peritoneal dialysis, per 10 ml
Blood collection tube, vacuum, for dialysis, per 50
Serum clotting time tube, for dialysis, per 50
Blood glucose test strips, for dialysis, per 50
Occult blood test strips, for dialysis, per 50
Ammonia test strips, for dialysis, per 50
Protamine sulfate, for hemodialysis, per 50 mg
Disposable catheter tips for peritoneal dialysis, per 10
Plumbing and/or electrical work for home hemodialysis equipment