Home Support Coverage Guidelines

 
  CoxHealth Home Support developed the following reference tools as a guide to current medical necessity criteria for the insurance coverage of Durable Medical Equipment (DME) and supplies.

These reference tools will be reviewed and maintained on a consistent and quarterly basis. Significant changes that occur more frequently will be updated accordingly. These reference tools are based upon criteria for the five most utilized insurances at CoxHealth Home Support which are Medicare, Medicaid, Blue Cross/Anthem, CoxHealth Plans and United Healthcare. It is divided into sections by the type of equipment/service being utilized. For items not included in these reference tools or questions, please contact the Order Intake department at CoxHealth Home Support for specifics to your situation.

It is our hope that these reference tools will lend some consistent clarity to insurance coverage details for Ordering Providers, Customer Service staff, Clinical staff and ultimately the Patient /Customer.

Sincerely,
Mike Williams, General Manager

Medicare Provider/Supplier responsibilities
 
 
Equipment Coverage
  1. AFO (Ankle/Foot Orthoses)
  2. Apnea Monitors
  3. Breast Prosthesis/Bra's
  4. Canes/Crutch
  5. Commode
  6. Compression Hose
  7. CPM (Continuous Passive Motion)
  8. Diapers/Incontinence
  9. Group 1, 2 and 3 Support Surfaces
  10. Hospital Bed
  11. Knee Orthoses
  12. Knee Walker
  13. Neuromuscular Electrical Stimulator
  14. Oxygen
  15. Patient Lift
  16. Phototherapy Light

  1. Power Mobility
  2. Pulse-Ox
  3. Seat lift Mechanism
  4. Diabetic Shoes & Inserts
  5. Spinal Orthoses
  6. Suction Machine
  7. TENS (Transcutaneous electrical nerve stimulation)
  8. Trach Supplies
  9. Traction
  10. Trapeze
  11. Treatment Compressor
  12. Upper Limb Orthoses
  13. Vacuum Erection Device
  14. Ventilators
  15. Walker
  16. Wheelchair
  17. Wheelchair Accessories
 
 
Additional Information
  1. Advanced Beneficiary Notice
  2. Helpful Links
  3. Pre-cert Criteria
  4. Rules of Return

  1. Rules of Repair
  2. Top payor quick guide
  3. Warranty Information