Outsourcing to DME Billing Company is the best way to optimize your workflow by knowing the DME billing coverage limitations and exclusions.

1. DME Billing Coverage Limitations and
Exclusions
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Durable medical equipment (DME) billing is an essential aspect of
revenue cycle management in the healthcare industry. As the industry
evolves, DME has grown in importance and now serves millions of
patients. However, managing the billing processes and reimbursements
associated with DME can be time-consuming and labor-intensive.
DME billing is becoming more of an administrative burden for healthcare
providers as regulatory requirements continue to grow. In fact, the DME
billing process is prone to numerous mistakes and errors due to such
complexities. If not addressed properly, these errors can result in claim
denials or rejections, resulting in significant losses for the DME provider.
Here are some of the most common DME billing requirements one must
be aware of to receive the adequate reimbursement amount for the
services provided.

2. DME Billing Coverage Limitations and
Exclusions
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3. DME Billing Coverage Limitations and
Exclusions
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What is DME Billing?
The process of generating and submitting claims for the durable medical
equipment provided is called DME billing. However, DME billing does not cover
equipment or devices that are used for convenience rather than a medical
need of the patient.
What is DME Coding?
DME billing companies, data analysts, and coding specialists submit insurance
claims using HCPCS (Healthcare Common Procedure Coding System) codes.
This DME coding system contains a list of all the codes used in DME billing
services. These codes aid in the tracking of supplies and equipment given to
patients. As a result, Medicare and other insurers can process health insurance
claims more efficiently. HCPCS code E0639, for example, denotes a moveable
patient lift system.

4. DME Billing Coverage Limitations and
Exclusions
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DME Billing Coverage Conditions
DME billing services can be covered only when the following conditions
are fulfilled:
When a patient has DME benefits and the equipment is recommended
by a healthcare professional to treat or diagnose a long-term disease or
illness, and the equipment is not otherwise excluded in the patient
benefit plan document or history.
DME Billing Coverage Limitations
Being a DME biller, one should be aware of various DME billing
coverage limitations. They can be as follows:
1. If a patient uses one or more DME to meet functional needs, coverage
benefits are only applicable and available for one DME that meets the
minimum patient requirements. They are as follows:
Custom wheelchair vs. standard power wheelchair
Standard vs. semi-electric vs. complete electric vs. floating bed
2. When a patient purchases or rents a DME that exceeds the guidelines
outlined above, the patient is responsible for the cost difference between
the items or devices purchased or rented.

5. DME Billing Coverage Limitations and
Exclusions
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DME Billing Coverage Exclusions
DME billing services cover all those accessories or devices that are
primarily intended for the comfort and convenience of the patient.
However, the following DME devices are not covered by insurance
companies:
Air purifiers and filters
Air conditioners
Non-medical equipment batteries
Humidifiers
Non-medical mobility devices. This exclusion does not apply to coverage
for Pediatric DME billing.
Remodeling or DME modification to home or vehicle to accommodate
DME or a patient condition.

6. How to Streamline the DME Billing
Process?
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Streamlining the DME billing process can result in higher
reimbursements for your medical practice. Outsourcing to your DME
billing partner, such as 24/7 Medical Billing Services, is the best way to
optimize your DME billing workflow! Outsourcing DME billing
operations will allow you to benefit from the expertise of DME billing
specialists. You can stay up to date on policy changes, payor guidelines,
regulation updates, and so on. Moreover, these professional DME billers
and coders can help you focus on your core expertise, providing quality
healthcare to your patients. Reach our experts to know more about our
DME billing services.

7. About Us
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We are a medical billing company that offers ‘24/7 Medical Billing
Services’ and support physicians, hospitals, medical institutions and
group practices with our end to end medical billing solutions. We help
you earn more revenue with our quick and affordable services. Our
customized Revenue Cycle Management (RCM) solutions allow
physicians to attract additional revenue and reduce administrative
burden or losses.

8. Contact Us
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Media Contact:
24/7 Medical Billing Services
Georgia
3001 Greenfield Drive, Marietta GA
Ohio
28405 Osborn Road, Cleveland, OH 4414030068
Texas
2028 E Ben White Blvd, #240-1030 Austin TX, 78741
Delaware
16192 Coastal Highway, Lewes, Delaware 19958, United States
Phone no / Fax : +1 888-502-0537
Email us: info@247medicalbillingservices.com