DME means Durable Medical Equipment.
Medical equipment’s that are utilized by the provider in treatment of the procedure or it’s prescribed by the provider to the patient, which is appropriate to use in the home and helps to boost patient’s daily activities.
It means DME is principally used to help in for a medical purpose, can endure for repeated use and suitable to use in the home.
For samples of Durable Medical Equipment is:
Wheelchair, Walker, Hospital beds, CPAP devices, Oxygen equipment, Nebulizers, Blood testing strips, Commode Chairs, Crutches, Medical supplies and so on.
Important Note:
Let us see some of the important and frequently used modifier we come upon while billing DME in medical billing:
KX modifier is used to indicate required documentation is on file to support the medical necessity of the item.
RT – Right side
LT – Left side
If the item is rented from the beneficiary, then below modifier are used:
RR modifier is used to indicate rental equipment.
Along with the RR modifier we used any one of the below modifier to identify the month of the rental item billed:
If the item is purchased from the beneficiary, then below modifier are used:
NU modifier is used to indicate Purchase of new equipment
UE modifier is used to indicate purchase of used equipment
DME written order needs to have detailed description of the item signed and dated by physician. Also it should have beneficiary name with complete address.
It is a signature on the order form (Proof of Delivery) along with the date from the beneficiary, which states beneficiary received the ordered item and also it determines the DME carrier to pay the amount to the DME supplier.
Certain DME equipment require CMN form from a doctor to support the medically necessity of the item to a beneficiary in order to reimburse the claim for DME supplier.
The most DME denials in Medical billing are as follows:
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