decisionhealth Newsletters, Answer Books - 2006 Issue 7 (July)
Medicare_Benefit_Policy_Manual / Chapter_15 / 110.4
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Article Overview
This article is a Medicare Benefit Policy Manual section focused on durable medical equipment coverage issues. It addresses general policy considerations around equipment purchase and rental, beneficiary disposition of equipment, situations involving suspected artificial expenses, and responsibility for unpaid charges when coverage ends. The material is relevant to Medicare DME suppliers, contractors, and billing/coding professionals who need to understand the scope of this coverage guidance.
Why This Topic Matters
Understanding this policy helps readers recognize how Medicare treats common DME payment scenarios and where coverage questions may require case-by-case review. It also highlights situations that may be referred for program integrity review and clarifies responsibility for remaining noncovered balances.
What You Will Learn
- How Medicare discusses miscellaneous coverage issues related to durable medical equipment
- The general policy context for purchase, rental, and subsequent disposal of equipment
- How coverage questions involving possible abuse or artificial expenses are addressed
- What happens when payment stops because medical necessity ends or the beneficiary dies
Who Should Read This
- Medicare suppliers
- Durable medical equipment providers
- Medical coders
- Billing staff
- Medicare contractors
- Compliance and program integrity personnel
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