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Uplift Commode Assist
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U.S. Medicare Coverage
You
may be eligible to receive a portion of your money back from
Medicare when you purchase an Uplift Commode Assist. To qualify,
you must have Medicare Part B coverage, and meet certain medical
coverage criteria as determined by your physician.
Here
are some common questions regarding Medicare
reimbursement.
What
will Medicare pay for an Uplift Commode Assist?
If
you qualify, Medicare will pay for 80% of the Medicare allowable
cost of your Uplift Commode Assist. This is what is called
a “capped rental item”, and the monthly allowable is from
$36.14 to $45.86, depending on your state of residence. (Ask
your Home Medical Equipment Provider for the exact amounts
for your state).
The
Uplift Commode Assist may be rented by Medicare for up to
15 months, and if you choose to do so, you also have the option
to purchase after 10 months rental. Ask your Home Medical
Equipment Provider for more details.
How
do I know if I qualify?
Medicare
has certain medical criteria that needs to be met before it
will pay for an Uplift Commode Assist.
Medicare
requires that your physician determine and document that the
use of an Uplift Commode Assist is a medical necessity for
you based on your medical condition. First, you must require
the use of a bedside commode. Additionally, Medicare will
only pay for an Uplift Commode Assist if you have a neuromuscular
disease or severe arthritis of the hip or knee that completely
prevents you from standing up from a regular armchair or any
chair in your home. Medicare also requires that, once standing,
you have the ability to walk.
Additionally,
the Uplift Commode Assist must be part of your doctor’s course
of treatment and be prescribed to improve, arrest or retard
deterioration in your condition. To see if you qualify, have
your physician complete the Certificate of Medical
Necessity (CMN) and return it to your Home Medical
Equipment Provider for review.
How
do I submit a claim to Medicare? What other information needs
to be sent?
Once
you have a completed PCF or a written order (prescription)
from your doctor, your Home Medical Equipment Provider will
supply you with an Uplift Commode Assist and submit a claim
to Medicare on your behalf. Medicare will process your claim
and inform you of their payment decision in about 30-45 days.
Uplift
Commode Assist - HCPCS Code EO169
“Commode
chair with seat lift mechanism.”
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