DME equipment
From Guide to YKHC Medical Practices
Standard Commode
- Patient is physically incapable of utilizing toilet facilities. This would occur in the following situations:
- The patient is confined to a single room (confinement to a single room means the patient is bedridden, cannot walk with a cane or walker, or cannot use or be wheeled in a wheelchair to access the bathroom) OR
- The patient is confined to one level of the home environment and there is no toilet on that level, OR
- The patient is confined to the home and there are no toilet facilities in the home
- Height and Weight within 30 days of prescription
Extra Wide/Heavy Duty Commode Chair
- Patient meets standard commode requirements AND
- Weight > 300lbs documented in medical record within 30 days of prescriptions
Drop-Arm Commode
- Patient meets standard commode requirements AND
- Detachable arms feature is necessary to facilitate transferring the patient or if the patient has a body configuration that requires extra width
A commode is NOT covered by Medicare for the following conditions/situations:
- Urinary urgency or incontinence
- Slow gait and cannot get to the bathroom in a timely manner
- Patient is able to walk with or without an assistive device, are able to use a wheelchair in the home, and are able to get to the bathroom
Semi Electric Hospital Bed
- One or more of the following criteria:
- Medical condition which requires positioning of the body in ways not feasible with an ordinary bed
- Requires positioning of the body in order to alleviate pain
- Requires head of bed to be elevated more than 30 degrees most of the time due to congestive heart failure, chronic pulmonary disease, or problems with aspiration
- Requires traction equipment, which can only be attached to a hospital bed
- Requires frequent changes in body position and/or has an immediate need for a change in body positions (i.e. a patient has large or multiple pressure ulcers on the trunk or pelvis and needs to be repositioned frequently and is unable to do so without assistance; or the patient has limited strength to move or shift their body)
Height: _ Weight: _ Wheelchair size: _
Standard Manual Wheelchair
- All of the following criteria are met:
- Mobility limitations impairing MRADLs (mobility-related activities of daily living: toileting, feeding, dressing, grooming, bathing, etc) in customary locations in the home
- Cannot be sufficiently resolved with a cane or a walker
- Will improve the patient’s ability to participate in MRADLs
- Client will to use wheelchair
- Height and weight within 30 days of prescription
- AND one of the following are met:
- Patient able to safely propel wheelchair themselves
- Caregiver available and will to push client in chair
Hemi Wheelchair
- Standard Manual Wheelchair criteria met AND one of the following:
- Lower seat height (17” to 18”) required due to short stature
- Patient needs to place feet on the ground for propulsion
Lightweight Wheelchair
- Standard Manual wheelchair criteria met AND both of the following:
- Unable to self-propel in standard chair
- Able to self-propel in lightweight chair
Heavy Duty Wheelchair
- Standard manual wheelchair criteria met AND one of the following:
- Weight over 250 lb
- Severe spasticity
Extra Heavy Duty Wheelchair
- Standard wheelchair criteria met AND
- Weight over 300 lbs