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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Wheelchair, fixed full length arms, swing away detachable elevating legrests
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Manual adult size wheelchair, includes tilt in space
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Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests
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Amputee wheelchair, fixed full length arms, without footrests or legrest
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Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest
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Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests
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Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests
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Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests
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Amputee wheelchair, fixed full length arms, swing away detachable footrest
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Wheelchair; specially sized or constructed, (indicate brand name, model number, if any) and justification
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Continued
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Wheelchair with fixed arm, footrests
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Wheelchair with fixed arm, elevating legrests
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Wheelchair with detachable arms, footrests
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Wheelchair with detachable arms, elevating legrests
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Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each
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Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each
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Special height arms for wheelchair
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Special back height for wheelchair
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Wheelchair, pediatric size, not otherwise specified
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Power operated vehicle (three or four wheel nonhighway) specify brand name and model number
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Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system
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Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system
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Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system
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Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system
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Wheelchair, pediatric size, rigid, adjustable, with seating system
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Wheelchair, pediatric size, folding, adjustable, with seating system
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Wheelchair, pediatric size, rigid, adjustable, without seating system
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Wheelchair, pediatric size, folding, adjustable, without seating system
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Power wheelchair, pediatric size, not otherwise specified
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Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest
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Continued
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Lightweight wheelchair, fixed full length arms, swing away detachable footrest
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Lightweight wheelchair, detachable arms (desk or full length) swing away detachable footrest
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Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests
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Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests
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Heavy duty wheelchair, fixed full length arms, swing away detachable footrest
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Heavy duty wheelchair, detachable arms (desk or full length) swing away detachable footrest
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Heavy duty wheelchair, fixed full length arms, elevating legrest
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Special wheelchair seat height from floor
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Special wheelchair seat depth, by upholstery
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Special wheelchair seat depth and/or width, by construction
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Whirlpool, portable (overtub type)
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Whirlpool tub, walk-in, portable
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Whirlpool, non-portable (built-in type)
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Oxygen accessory, flow regulator capable of positive inspiratory pressure
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Regulator
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Oxygen accessory, wheeled cart for portable cylinder or portable concentrator, any type, replacement only, each
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Stand/rack
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Oxygen accessory, battery pack/cartridge for portable concentrator, any type, replacement only, each
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Oxygen accessory, battery charger for portable concentrator, any type, replacement only, each
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Oxygen accessory, dc power adapter for portable concentrator, any type, replacement only, each