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.
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Traction stand, free standing, extremity traction
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Traction frame, attached to footboard, pelvic traction
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Traction stand, free standing, pelvic traction, (e.g., buck's)
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Trapeze bars, a/k/a patient helper, attached to bed, with grab bar
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Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar
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Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar
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Fracture frame, attached to bed, includes weights
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Fracture frame, free standing, includes weights
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Continuous passive motion exercise device for use on knee only
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Continuous passive motion exercise device for use other than knee
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Continued
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Trapeze bar, free standing, complete with grab bar
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Gravity assisted traction device, any type
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Cervical head harness/halter
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Pelvic belt/harness/boot
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Extremity belt/harness
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Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)
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Fracture frame, attachments for complex pelvic traction
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Fracture frame, attachments for complex cervical traction
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Wheelchair accessory, tray, each
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Heel loop/holder, any type, with or without ankle strap, each
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Toe loop/holder, any type, each
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Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each
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Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot
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Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each
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Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each
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Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each
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Manual wheelchair accessory, one-arm drive attachment, each
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Manual wheelchair accessory, adapter for amputee, each
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Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware
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Manual wheelchair accessory, wheel lock brake extension (handle), each
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Continued
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Manual wheelchair accessory, headrest extension, each
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Manual wheelchair accessory, hand rim with projections, any type, replacement only, each
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Commode seat, wheelchair
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Narrowing device, wheelchair
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No. 2 footplates, except for elevating leg rest
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Manual wheelchair accessory, anti-tipping device, each
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Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each
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Manual wheelchair accessory, anti-rollback device, each
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Wheelchair accessory, positioning belt/safety belt/pelvic strap, each
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Safety vest, wheelchair
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Wheelchair accessory, seat upholstery, replacement only, each
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Wheelchair accessory, back upholstery, replacement only, each
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Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control
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Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control
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Wheelchair accessory, seat lift mechanism
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Manual wheelchair accessory, power assist system
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Manual wheelchair accessory, lever-activated, wheel drive, pair
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Wheelchair accessory, elevating leg rest, complete assembly, each
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Manual wheelchair accessory, solid seat insert
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Arm rest, each