A fixed height hospital bed is covered if one or more of the following criteria are met.
- The patient has a medical condition which requires positioning of the body in ways not feasible with an ordinary bed. Elevation of the head/upper body less than 30 degrees does not usually require the use of a hospital bed.
- The patient requires positioning of the body in ways that are not feasible with an ordinary bed in order to alleviate pain, or
- The patient requires the head of the bed to be elevated more than 30 degrees most of the time due to congestive heart failure, chronic pulmonary disease, or problems with aspiration, or
- The patient requires traction equipment, which can only be attached to a hospital bed.
Order Form (DWO)
Every order requires a written prescription. While prescriptions take many forms, DME prescriptions require several specific elements. Make sure to see the section on "Order Form (DWO)."
Face to Face Examination
For virtually all medical equipment that is used in the home, the patient needs to have a "Face to Face" examination. This simply means that the patient was seen and examined/treated for a condition that is related to the need for the item. Consider a simple example of a hospital admission for a broken leg. there is likely already a history and physical that discusses the examination of the broken leg. If so - this step is done!
Just about every piece of Medical equipment has coverage rules. These rules stem from Federal Law and dictate when an item is covered.
The items mentioned in the coverage rule need to be addressed by a clinician in the patient's chart notes. For example, when a patient needs a wheelchair, the doctor needs to determine that a cane or walker will not work. While he would usually just this mentally - now he needs to chart it.