B |
Product Name |
Covered/
Denied |
Explanation |
BATHTUB LIFT |
D |
convenience item; not primarily medical in nature. |
BATHTUB SEAT |
D |
comfort or convenience item; hygienic item; not primarily medical in nature. |
BED BATH |
D |
hygienic item; not primarily medical in nature. |
BED BOARD (MATTRESS SUPPORT) |
D |
convenience item; not primarily medical in nature. |
BED PAN (AUTOCLAVABLE HOSPITAL TYPE) |
C |
if the patient is confined to bed. NOT COVERED
if used in conjunction with a covered commode. |
BED SIDE RAILS |
C |
if the side rails are provided along with a hospital bed. |
BI-LEVEL POSITIVE AIRWAY PRESSURE EQUIPMENT (BIPAP S) |
C |
subject to the following conditions:
- the patient is diagnosed with moderate or severe Obstructive Sleep Apnea (OSA), and
- surgery is a likely alternative, and
- the physician documents that the patient finds the magnitude of pressure delivered through CPAP intolerable, or the physician establishes other rational for minimizing the delivered pressure.
Diagnosis of OSA must include documentation of at lease 30 episodes of apnea, each lasting a minimum of 10 seconds, during 6-7 hours of recorded sleep. Initial claims must also certify that
documentation supporting the diagnosis of OSA is available. |
BIPAP S/T |
|
See VENTILATOR. |
BIDET TOILET SEAT |
D |
hygienic item: not primarily medical in nature. |
BLOOD GLUCOSE ANALYZER (REFLECTANCE COLORIMETER) |
D |
unsuitable for home use. |
BLOOD GLUCOSE MONITOR AND SUPPLIES |
C |
if subject to the following conditions:
- insulin treated diabetic (i.e. Type I Diabetes Mellitus) or non-insulin treated diabetic (i.e. Type II Diabetes Mellitus)
- the physician must document poor diabetic control such as: widely fluctuating blood sugars before meal times; frequent incidents of insulin reactions; or evidence of frequent significant ketosis.
- the blood glucose monitor has been designed specifically for home use by diabetic patients, and
- the physician must certify that the patient or another family member is capable of being trained to use the particular blood glucose monitor prescribed in an appropriate manner.
- The patient must document the results on a log and keep a copy on file with the physician
Supplies
If blood glucose monitor coverage requirements are met, and the blood glucose monitor has been purchased, then all lancets, regent strips and other necessary supplies are also covered.
Utilization limits for supplies for insulin treated diabetic
- 100 test strips per month
- 100 lancets per month
- One spring powered device per six months
Utilization limits for supplies for non-insulin treated diabetic
- 50 test strips per month
- 50 lancets per month
- One spring powered device per six months
|
BLOOD PRESSURE MONITOR |
C |
if prescribed by a physician as part of a home hemodialysis system, a sphygmomanometer with cuff and stethoscope are covered. |
