Transcription of Durable Medical Equipment, Orthotics, Medical Supplies and ...
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Durable Medical Equipment, Orthotics, Medical Supplies and Repairs/Replacements Page 1 of 11 UnitedHealthcare Community Plan Coverage Determination Guideline Effective 07/01/2021 Proprietary Information of UnitedHealthcare. Copyright 2021 United HealthCare Services, Inc. UnitedHealthcare Community Plan Cover a ge Deter mina tion Guideline Durable Medical Equipment, Orthotics, Medical Supplies and Repairs/Replacements Guideline Number: Effective Date: July 1, 2021 Instructions for Use Table of Contents Page Application .. 2 Coverage Rationale .. 2 Definitions .. 7 Applicable Codes.
Durable Medical Equipment (DME), related supplies, and orthotics are covered when Medically Necessary and the following requirements are met: Medicare National Coverage Determination (NCD), CMS DME MAC Local Coverage Determination (LCD), Local Coverage
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