Durable Medical Equipment (DME) is any equipment that provides therapeutic benefits to a patient in need because of certain medical conditions and/or illnesses. DME must be found medically necessary, requires a prescription and should be authorized in advance, before it is eligible for coverage. Thus DME billing is fairly different, and more complex, from other types of medical billing and coding. It requires specialized, in-depth knowledge of all HCPCS Level II codes and the overall DME reimbursement process.
The complicated nature of this type of billing serves to be a challenge. With an increasing number of expensive medical equipment or DME being rented rather than purchased, billers and coders need to be aware of: