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Wheelchair Repair Form. DME 2025

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The document outlines the procedure for submitting a Wheelchair Repair Form to Nevada Medicaid, detailing the necessary medical documentation, information required from both the recipient and provider, and certification of accuracy. It emphasizes the importance of complete and accurate submissions to avoid delays or denials in authorization for repairs, as well as the responsibilities of Durable Medical Equipment (DME) providers.

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Versions	Form popularity	Fillable & printable
2021	4.8 Satisfied (21 Votes)
2019	4.4 Satisfied (113 Votes)
2015	4 Satisfied (32 Votes)

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What is the DME code for a wheelchair?

HCPCS E1130-E1160 Standard wheelchairs [includes codes E1130, E1140, E1150, E1160] E1161 Manual adult size wheelchair, includes tilt in space E1170-E1190 Amputee wheelchairs [includes codes E1170, E1171, E1172, E1180, E1190] E1195 Heavy duty wheelchair24 more rows

What is the code for DME repair?

HCPCS Code for Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes K0739.

Is a wheelchair part of DME?

Examples of DME Wheelchairs and scooters. Walkers, canes, and crutches. Blood sugar monitors and test strips. Respiratory equipment including oxygen, Continuous Positive Airway Pressure (CPAP) devices, and nebulizers.

Are wheelchair repairs covered by Medicare?

Medicare Part B covers medically necessary power mobility devices (PMDs), such as power wheelchairs, and PMD repairs that are reasonable and necessary to make the equipment serviceable.

What is not considered DME?

DME items cannot include common household items such as strollers, wraps, slings or soft-structured carriers. Documentation from the recipients physician, nurse practitioner, clinical nurse specialist or physician assistant of the recipients medical disability that justifies the need for the DME item.

What is covered under DME?

Medicare-covered DME includes, but isnt limited to: Blood sugar meters. Blood sugar test strips. Canes. Commode chairs. Continuous passive motion machines, devices accessories. Continuous Positive Airway Pressure (CPAP) machines. Crutches. Hospital beds.

What is a wheelchair classified as?

Wheelchairs and Mobility Aids The Americans with Disabilities Act (ADA) definition of a wheelchair (Title V Section 508c) is: a manually-operated or power-driven device designed primarily for use by an individual with a mobility disability for the main purpose of indoor or of both indoor and outdoor locomotion.

What equipment is considered DME?

DURABLE MEDICAL EQUIPMENT Reference List ItemCoverage Mobile Geriatric Chair (See Rolling Chairs.) Motorized Wheelchairs (See Wheelchairs (power operated).) Muscle Stimulators Covered for certain conditions. (See 250.4 of the NCD Manual.) Nebulizers Covered if patients ability to breathe is severely impaired.123 more rows

Wheelchair Repair Form. DME 2025

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