Download DME RENTAL ONLY Decubitus Care Equipment

Attachment A
DME RENTAL ONLY
Decubitus Care Equipment
E0193
E0194
E0277
Powered air flotation bed {low air loss therapy}
Air fluidized bed
Powered pressure-reducing air mattress
Infusion Equipment and Supplies
K0455
Infusion pump used for uninterrupted parenteral admin of medications
Oxygen and Related Equipment
E0431
E0442
E0450
E0460
E0461
E0471
E0472
E0483
E0618/19
E1390
Portable Gas Oxygen
Portable liquid oxygen system; includes portable container, supply reservoir,
flowmeter, humidifier, contents gauge, cannula or mask, tubing and refill adapter.
Volume ventilator, stationary or portable, with backup rate feature, used with
invasive interface (e.g., tracheostomy tube)
Negative pressure ventilator, portable or stationary
Volume ventilator, stationary or portable, with backup rate feature, used with noninvasive interface
Respiratory assist device, bi-level pressure capability, with back-up feature, used
with noninvasive interface (intermittent assist device with continuous positive
airway pressure device
Respiratory assist device, bi-level pressure capability, with back-up feature, used
with invasive interface (intermittent assist device with continuous positive airway
pressure device)
High frequency chest wall oscillation air-pulse generator system
Apnea Monitor
Oxygen concentrator, capable of delivering 85 percent or greater oxygen
concentration at the prescribed flow rate (includes accessories and set up)
Hospital Beds
E0297
Hospital bed, total electric (head, foot and height adjustment)
Miscellaneous
E0604
Breast Pump, heavy duty, hospital grade
E2402
Negative pressure wound therapy electrical pump, stationary or portable
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Attachment A
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