Air Cleaner – Purifier
Airway Clearance Devices – Positive Expiratory Pressure Device, Oscillating Positive Expiratory Device and Percussor
Ankle-Foot/Knee-Ankle-Foot Orthosis
Apnea Monitor
Automatic External Defibrillator
Bathroom Aids
Bed Related Accessories
Bedwetting Alarm for Nocturnal Enuresis
Bilirubin Light – Phototherapy
Blank Medical Policy Template
Blood Glucose Monitors
Blood Pressure Monitor
Bowel Irrigation Evacuation System
Breast Prosthesis and Supplies Following Mastectomy
Breast Pumps and Accessories
Canes and Crutches
Cervical Pillow
Cervical Traction Devices
Cervical Thoracic Orthosis (Halo Brace), Cervical Orthosis (Cervical Collar)
Cold Pad/Cold Pressure Therapy
Commode
Continuous Glucose Monitoring Systems
Continuous Passive Motion (CPM) Devices
Cranial Orthosis and Protective Helmets
Dehumidifier/Humidifier
DME General Policy
Drug Delivery System for MDI
Electrical Stimulation (ES) and Electromagnetic Therapy for the Treatment of Wounds in the Home Setting
Enteral Nutrition
Exercise Equipment
External Infusion Pump and Supplies
Eye Prosthesis
Facial Prosthesis
Hair Prosthesis
Heat and Moisture Exchanger
Heating Pad
High Frequency Chest Wall Oscillation (HFCWO) Devices
Hip Orthosis
Hospital Beds and Accessories
Incontinent Supplies
Insulin Infusion Pump and Supplies
Intrapulmonary Percussive Ventilation System
Jaw Motion Rehabilitation System
Knee Orthosis (Orthotic Devices – Lower Limb)
Lower Limb Prosthesis
Lumbar Traction Devices (Home)
Lymphedema Pump – Pneumatic Compression Pump
Manual Wheelchair Bases
Massage Devices
Mechanical In-Exsufflation Devices
Mechanical Stretch Devices for Contractures and Joint Stiffness
Myoelectric Upper Limb Prostheses
Nebulizers/Compressors
Negative Pressure Wound Therapy Pumps and Wound Suction Pumps
Neuromuscular Electrical Stimulation (NMES) Devices
Non-Contact Normothermic Wound Therapy (NNWT)
Non-Implantable Pelvic Floor Electrical Stimulator
Non Invasive Vagus Nerve Stimulator
Orthopedic Footwear
Osteogenesis Stimulators – Spinal and Nonspinal
Ostomy Supplies
Oxygen and Oxygen Equipment
Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea
Paraffin Bath Unit, Portable
Patient Lifts
Pessary
Power Mobility Devices
Powered Exoskeleton Orthosis
Pressure Gradient Garments and Support Stockings
Pressure Reducing Support Surfaces – Group 1
Pressure Reducing Support Surfaces – Group 2
Pressure Reducing Support Surfaces – Group 3
Protective or Enclosure Beds
Pulse Oximeter for Home Use
Respiratory Assist Devices
Seat Lift Mechanisms
Sitz Bath
Speech Aid/Artificial Larynx
Speech Generating Devices
Spinal Orthoses
Stander Policy
Suction Pumps
Surgical Dressings
Therapeutic Light Box for Seasonal Affective Disorder (SAD)
Therapeutic Shoes for Individuals with Diabetes
Tracheostomy Care Supplies
Transcutaneous Electrical Nerve Stimulators (TENS)
Transport Chair/Roll about Chair
Truss
Ultraviolet Light Therapy
Upper Extremity Orthoses
Urological Supplies
Vacuum Erection Devices
Vaporizer
Ventilators
Vitrectomy Support System
Walker
Wheelchair Cushions Seating Systems
Wheelchair Options Accessories
