Before an item can be considered DME, it must meet all of the following requirements:
It must be able to withstand repeated use.
It must be primarily and customarily used to serve a medical purpose.
It must be generally not useful to a person in the absence of an illness or injury.
It must be appropriate for use in the home.
All E codes fall under the jurisdiction of the DME MAC unless otherwise noted.
Custom fabricated wheelchair back cushion, any size, including any type mounting hardware
Replacement cover for wheelchair seat cushion or back cushion, each
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware
Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware
Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth
Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth
Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth
Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth
Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable
Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type
Continued
Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining
Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)
Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support
Wheelchair accessory, addition to mobile arm support, elevating proximal arm
Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control
Wheelchair accessory, addition to mobile arm support, supinator
Speech volume modulation system, any type, including all components and accessories
Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only
Gait trainer, pediatric size, posterior support, includes all accessories and components
Gait trainer, pediatric size, upright support, includes all accessories and components
Gait trainer, pediatric size, anterior support, includes all accessories and components