What Is Hme In Healthcare?

What Is Hme In Healthcare
Home Medical Equipment (HME) is a category of medical equipment and supplies supplied and maintained by HME providers and used by patients whose care is being managed in their own home or community, rather than an institution setting.

What does HME mean in medical terms?

Diagnosis – Human Monocytic Ehrlichiosis (HME) may be diagnosed based upon a thorough clinical evaluation, characteristic findings, and specialized laboratory tests. Blood tests may reveal findings often associated with the Human Ehrlichioses such as abnormally low levels of blood platelets (thrombocytopenia), low levels of certain white blood cells (leukopenia), and/or elevated levels of certain liver enzymes (such as aspartate aminotransferase and alanine aminotransferase ).

In some cases, laboratory tests may reveal abnormalities of the cerebrospinal fluid. In addition, chest X-rays may reveal abnormalities in the lungs (e.g., pulmonary infiltrates, increased fluid in the lungs). Examination of blood smears under a microscope that uses an electron beam (electron microscopy) may reveal clusters of bacteria in membrane-bound cavities (vacuoles) within certain cells (e.g., monocytes); however, such clusters may not be apparent early in the course of infection.

In some cases, additional specialized laboratory tests may then be conducted to help determine and/or to confirm a diagnosis of a specific bacterial infection. Specialized laboratory tests may include Indirect Immunofluorescence Assays (IFA) conducted on the fluid portion of an affected individual’s blood (serum).

Antibodies, which are proteins manufactured by certain white blood cells, help the body fight toxins and invading microorganisms. In Indirect Immunofluorescence Assays, human antibodies are marked with special fluorescent dyes and a microscope with ultraviolet light is used, enabling researchers to observe antibody response to certain microorganisms.

IFA testing has been used in confirming a diagnosis of all known types of Human Ehrlichial infection. However, in Human Monocytic Ehrlichiosis (HME), the bacterium responsible for the infection (Ehrlichia chaffeensis) was not characterized and identified (isolated) until 1991.

Therefore, for many years, HME infection was diagnosed by observing the antibody response in a patient’s blood serum to the bacterium responsible for Canine Ehrlichiosis, Ehrlichia canis, a bacterium that is very genetically similar to E.
Chaffeensis. Since E.
Chaffeensis was isolated in 1991, cases of HME have been confirmed by IFA testing that measures antibody response either to E.

chaffeensis itself or the closely-related E. canis. Measurable diagnostic rises in antibody response to the Ehrlichia bacteria may not occur until approximately three weeks after the onset of Human Monocytic Ehrlichiosis. As a result, initial IFA blood serum results may be negative in some cases.

Therefore, more sensitive testing techniques that can help establish early diagnosis may be used in some cases. One such process, called Polymerase Chain Reaction (PCR), is a laboratory technique in which sequences of DNA (which contains the organism’s genetic information) can be copied over and over again quickly.

This enables close analysis of the DNA, aiding in the identification of the organism in question. PCR conducted on certain bacterial DNA sequences obtained from patients’ blood samples may confirm Human Ehrlichial infection due to a particular strain of Ehrlichia.

PCR has been used to establish an early diagnosis of Human Ehrlichial infection in some cases of HME. The information in the medical literature indicates that because it may be difficult to differentiate Human Ehrlichial infection, such as Human Monocytic Ehrlichiosis, from other illnesses that are also characterized by high fever (febrile illnesses), Ehrlichiosis should be considered in any patient with high fever, thrombocytopenia, and leukopenia who has recently been exposed to ticks.

In addition, HME should be considered in individuals with high fever, severe headache, and neurologic symptoms, particularly in areas where HME infection is known to occur and during peak seasons for such infection. If HME is suspected, treatment should not be delayed until diagnosis has been confirmed by IFA testing, since a positive antibody response may not occur until several weeks after initial infection.

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What is the difference between HME and DME in medical terms?

DME is what we use, HME services is what we do Guest Blog By HME News Staff Updated Thu January 7, 2016 Historically, items like hospital beds, oxygen tanks and concentrators, wheelchairs, commodes, ambulatory aids, compressors and other items that could be used to support a medical need on an ongoing basis were referred to as DME.

This is clearly an accurate, but one-dimensional definition.
Health insurance carriers, Medicare included, covered these items as a “DME” benefit when a doctor indicated that there was medical necessity requiring the use of any of these items.
This one-dimensional view of DME never took into consideration that the item is DME, but providing these items is HME services.

Providing medical equipment services to patients in their homes has never been one-dimensional. From the beginning, HME services has always been multi-dimensional. In almost all cases, the patients needing DME required the following: 1. Delivery 2. A home assessment to verify the appropriateness and safety of the prescribed item.3.

On use and operation with return demonstration. Maintenance. How to seek assistance in the case of operational failure. How to report changes in medical conditions

5. Assistance in verifying insurance coverage.6. Gathering needed documentation to support the medical necessity for such items.7.24/7 availability of assistance for emergency after hours and holiday service.8. Billing insurance carriers on behalf of the patients and caregivers.9.

Advocating on behalf of the patient where reimbursement was challenged by the insurance carriers.10. Eventually, in most instances, the retrieval of such DME items where purchase was not met. This is HME services. This is what has always been required, this is what patients and their insurance carriers were paying for, never was it only the DME.

For a provider to adequately support patients with HME services, the providers needed to do the following: 1. Hire and train staff in the following disciplines:

All insurance carriers coverage criteria for all DME items Communication with medical professionals Communication with ailing patients and non-medical caregivers. The operation and maintenance in all types of DME items. Sanitation and reconditioning of returned DME items. Safe vehicle practices and maintenance processes.

2. Establish communication processes that make the provider available to patients 24/7 for emergency service.3. Establish processes for internal communication on handling patient needs 4. Procure necessary transportation equipment 5. Procure necessary communication equipment and services such as pagers, cell phones, computers, and answering services.6.

Where required, become licensed and/or certified in their state to operate.7. Undergo elaborate, expensive accreditation preparation and surveys.8. FDA licensure for oxygen 9. Have associates go through rigorous manufacturer training programs to become proficient in the operation and maintenance of all DME items.

DME is one-dimensional; it refers only to the items. HME services is multi-dimensional and specific to the home and everything that is necessary to help patients maintain themselves safely in their own places of residences. A 1,000-bed hospital facility can operate with an economy of scale.

They can inventory and staff accordingly, knowing that their patients are in a compact, defined area. HME providers run 1,000-bed hospitals in 1,000 different locations. They need to inventory, staff and maintain the logistics and communication procedures to service 1,000 patients in 1,000 different locations when needed, 24/7.

Since 1965, when Medicare was implemented, the array of medical equipment designed to maintain patients at home has exploded. Items have become more technical, more reliable, easier for patients and caregivers to use, and more accessible to patients in need in a timely manner.

In 1965, HME services were provided by delivery technicians and, occasionally, respiratory therapists.
Today, HME services are more sophisticated and technical, and need to be provided by highly trained clinicians with multiple disciplinary backgrounds: pharmacists, nurses, dieticians, diabetic counselors, physical therapists, respiratory therapists, etc.

In 1985, the average length of stay in a hospital was 8.5 days. Today, the average length of stay is less than 4.5 days. One of the main reasons for this drastic reduction in the length of stay is because of the development and availability of more sophisticated HME items to help get and maintain sicker patients back to their home environment sooner.

Healthcare costs are soaring out of control in the skilled environments. In such environments, patients incur costs for their health care, their healthcare items, their room and their board. At home, the only costs are the healthcare services that keep them safely at home. Today, HME services are still viewed by payers and legislators as DME, a one-dimensional line item, and reimbursement rates are shrinking to the point that the following is happening: 1.

There is almost no R&D to develop new technology to help even sicker patients get home sooner.2. The provider base has been reduced so that timely availability of services is more and more difficult to find.3. Patients are staying longer in skilled environments due to lack of accessibility.4.

Providers that are still in business are forced to cut back staff and, therefore, services.5. The ill patients and caregivers are being forced to find ways to get to providers for services or go without.6. Providers are forced to buy equipment based upon cost, not reliability. CMS can talk all they want about how the quality of care has not been affected by lower reimbursement rates, but the reality is that nowhere in the country where there is national competitive bidding are Medicare patients being cared for as well as areas not yet affected by NCB.

If Medicare wants to create a warehouse in each state where patients can go and take what they need off the shelf by themselves, take it home, learn how to safely use it, then you can talk about DME. By definition, ailing patients can’t do that and need individual and personal care to save money by keeping and maintaining safely in the cost effective environment of their home.

HME services is multi-dimensional and needs to be recognized and reimbursed as such to be effective.
DME is a tool requiring HME services to make it work.
Between 2007 and 2013, by Medicare’s own figures, the cost of Part A increased 70%.
In that same time frame, Part B remained flat despite more people turning 65 daily.

Contrary to the common wisdom, Part A and Part B are related. If HME services are not recognized and supported, Part A will continue to spiral out of control. DME is what we use, HME services is what we do. HME services saves lives—and healthcare dollars.

What is an HME facility?

Any person or entity that offers to sell or rent to a consumer any home medical equipment and provides equipment related services such as delivery, set up and maintenance of the equipment.

What is the full form of HME DME?

What Is Home Medical Equipment? – Home medical equipment is a category of devices used for patients whose care is being managed from a home or other private facility managed by a nonprofessional caregiver or family member. It is often referred to as “durable” medical equipment (DME) as it is intended to withstand repeated use by non-professionals or the patient, and is appropriate for use in the home.

DME: Durable Medical Equipment HME: Home Medical Equipment DMEPOS: Durable Medical Equipment, Prosthetics, Orthotics and Supplies

What is the abbreviation for durable medical equipment?

Durable medical equipment ( DME )

What does HME mean in text?

Meaning. HME. Happy Meal Ethernet (UNIX driver) HME.

What does HME mean on ventilator?

To the Editor – Pulmonary dead space under general paediatric anaesthesia is a useful and relevant parameter, We know that Heated Moisture Exchanger (HME) may lead to larger dead space and can negatively impact mechanical ventilation and gas exchange, Smaller HME appears to be preferable, but there is a lack of information regarding their applicability and suitability in paediatric population, On this issue, Kwon analyzed the effects of HME on dead space in 20 relatively healthy paediatric patients, during their exposure to general anaesthesia for minor surgical procedures. We would like to congratulate the authors on their original hypothesis and results, which have clinical crucial implications. They reported that PaCO2 was significantly influenced by HME and the difference was correlated with weight (P < 0.001) and age (P = 0.002) of a patient. However, some major considerations and questions should be taken into consideration for the definitive clinical implications of their results. Firstly, clinical consequences of the removal of HME for 15 minutes without compensatory use of another artificial humidification may lead to serious implications, such as cilia and endothelial injury, increase in airway resistance, hypothermia, and etc., We have not been provided with any information in regards to these well known consequences, as well as whether or not any attempt was made to measure such complications. Secondly, there is insufficient information on the baseline of mechanical ventilation in both situations, which may influences our interpretation of higher pCO2 levels, We have no information regarding the airway resistance, compliance, or peak airway pressure, which could help us for a better interpretation, It would have been important to know the difference in PaCO2 between the baseline and after experimentation rather than just knowing the difference at the end of the experiment, It is hard to determine whether or not the reduction is temporal and not a direct influence. Thirdly, main thrust of this report is on the alteration in physiological variables rather than clinically important outcomes, such as length mechanical ventilation or influence on weaning, Overall, this report does not answer what are clinically important questions, such as which device is better for humidification, what effects of clinically important outcomes can be derived from this experiment and how best to use humidification without causing lung injury. In our opinion, this attractive and original report fails to even bridge a tile in this puzzle of humidification during healthy pediatric anesthesia.

Is HME a ventilator?

Heat and moisture exchanger

This article includes a list of general, but it lacks sufficient corresponding, Please help to this article by more precise citations. ( March 2012 ) ( )

Heat and moisture exchangers (HME) are devices used in patients intended to help prevent complications due to “drying of the respiratory mucosa, such as mucus plugging and endotracheal tube (ETT) occlusion.” HMEs are one type of commercial humidification system, which also include and,

What are the different types of HME?

OVERVIEW – The respiratory tract heats and humidifies gas entering the lungs, so it is warmed to body temperature and fully saturated with water vapor. The upper airway provides 75% of the heat and moisture supplied to the alveoli. When the upper airway is bypassed by an artificial airway during invasive mechanical ventilation, humidification must be added to the dry inhaled gas.

Humidity is necessary to prevent hypothermia, disruption of the airway epithelium, bronchospasm, and atelectasis, and it keeps airway secretions thinned. In severe cases, thick airway secretions may occlude the artificial airway or obstruct the lower airways. Two types of humidification systems are available for use with mechanical ventilation: (1) active heated humidifier (HH), and (2) passive HME.

During normal respiration, the humidity in the trachea ranges from 36 to 40 mg H 2 O/L, and the optimal required moisture below the carina is 44 mg H 2 O/L (100% relative humidity at 37°C ). Active HHs increase the heat and water vapor content of inspired gas.

The humidifier should provide a humidity level between 33 and 44 mg H 2 O/L and a gas temperature between 34°C and 41°C (93.2°F and 105.8°F) at the circuit Y-piece, with a relative humidity of 100% to prevent the drying out of secretions in the artificial airway. A maximum delivered gas temperature of 37°C (98.6°F) and 100% relative humidity (44 mg H 2 O/L) at the circuit Y-piece is recommended.

A relative humidity of 100% may be confirmed by the presence of condensate in the circuit Y-piece connector. HMEs operate passively by storing heat and moisture from the patient’s exhaled gas and releasing it to the inhaled gas. There are three types of HMEs: hydrophobic, hygroscopic, and filtered.

The HME should provide a minimum humidity level of 30 mg H 2 O/L. An HME is better than HH for short-term use (96 hours or less) and for use during transport. An HH should be used for patients who exhibit contraindications to HME use or who are on mechanical ventilation for an extended time. HMEs should not be used on patients with low tidal volumes or increased dead space, ventilation requirement, or arterial partial pressure of carbon dioxide (Pa CO 2 ) levels.

HMEs are contraindicated if the patient has:

Frank bloody or thick, copious secretions
Exhaled tidal volume of less than 70% of the delivered tidal volume
Body temperature below 32°C (89.6°F)
High spontaneous minute volumes (greater than 10 L/min)

What is an example of HME?

What is HME? – Home Medical Equipment, or HME, describes a category of medical supplies and devices used in a person’s home. HME equipment refers to any type of medical equipment or supplies used repeatedly, lasts for 3+ years, and serves a medical purpose. Examples of HME includes:

Crutches CPAP machines and supplies Hospital beds Oxygen tanks Prosthetic devices Walkers Wheelchairs and accessories

How does an HME work?

How does a HME Work? – A HME captures moisture from your exhaled breath so that as you inhale that moisture can be reused. It is usually is a foam-like or corrugated paper material encased in plastic. It is designed to connect to the breathing tube near the point of exhalation. What Is Hme In Healthcare

Why do we use HME?

Introduction – During spontaneous breathing, inspired gases are heated and humidified in the nose and pharynx. On reaching the bifurcation of the trachea, the temperature gets up to 37° Centigrade and absolute humidity reaches 44mg/L 1, However when natural airways are bypassed during endotrachael intubation, cold and dry gases are delivered to the patients, which need to be heated and humidified 2,

Hypothermia is defined as core temperature of less than 36º centigrad 3,Hypothermia has many complications namely, increased perioperative blood loss due to impaired blood coagulation pathways, altered drug metabolism, which leads to prolonged drug actions, delayed recovery and morbid cardiac events such as arrhythmias.

Others are post operative shivering, prolonged hospital stay and patients’ less satisfaction with surgical and anaesthesia experience 4, Lastly, hypothermia results in impaired wound healing and susceptibility to wound infection 5, Better postoperative outcomes are achieved when normothermia is maintained perioperatively 6,

Commonly used methods of humidifying inspired gases include heated humidifiers (HH), heat and moisture exchangers (HME) and hygroscopic condenser humidifiers.
Heated humidifiers provide warm, saturated gas at the artificial airway; but they are bulky, require frequent care giver attention to function well and may be a source of infection secondary to aspiration of water that runs out of the ventilator circuit 7,

On the other hand, HMEs function by conserving heat and moisture during expiration and make these available to the incoming dry medical gases during the subsequent inspiration 8, Advantages of HMEs include, portability, light weight, simple, passive generation of heat and low cost compared to heated humidifiers.

They serve three main purposes, warm and humidify air in the respiratory tract, protect patients from contamination from anaesthetic equipment and from contaminating the anaesthetic breathing circuit 9,
Surgery associated with exposed intra- abdominal cavity is more likely to be associated with heat loss than peripheral surgeries.

Presently there is a dearth of literature on the use of HMEs in the prevention of perioperative hypothermia in the West African sub-region. This study therefore sought to evaluate the effectiveness of HMEs in preventing perioperative hypothermia among abdominal surgeries.

What is HME CPAP?

The MaxMed Heat Moisture Exchange filter (HME) for CPAP machines is designed to provide passive humidification during CPAP therapy. The HME filter is attached to a mask elbow in order to take in heat and moisture from the user’s exhaled breath.

What does DME stand for in healthcare?

Your costs in Original Medicare – After you meet the Medicare-Approved Amount (if your supplier accepts assignment ). Medicare pays for different kinds of DME in different ways. Depending on the type of equipment:

You may need to rent the equipment. You may need to buy the equipment. You may be able to choose whether to rent or buy the equipment.

Medicare will only cover your DME if your doctors and DME suppliers are enrolled in Medicare. Doctors and suppliers have to meet strict standards to enroll and stay enrolled in Medicare. If your doctors or suppliers aren’t enrolled, Medicare won’t pay the claims they submit.

Make sure your doctors and DME suppliers are enrolled in Medicare. It’s also important to ask a supplier if they participate in Medicare before you get DME. If suppliers are participating in Medicare, they must accept assignment (which means, they can charge you only the coinsurance and Part B deductible for the Medicare‑approved amount).

If suppliers aren’t participating and don’t accept assignment, there’s no limit on the amount they can charge you.

What is another name for durable medical equipment?

Home › Durable Medical Equipment (DME) Durable Medical Equipment (DME) Durable medical equipment (DME), also known as DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies) is equipment that primarily serves a medical purpose, is able to withstand repeated use, and is appropriate for use in the home; for example, wheelchairs, oxygen equipment, and hospital beds. Medicare only covers DME if your provider says it is medically necessary for use in the home. ” data-gt-translate-attributes=””>Durable medical equipment (DME), also known as DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies) is equipment that primarily serves a medical purpose, is able to withstand repeated use, and is appropriate for use in the home; for example, wheelchairs, oxygen equipment, and hospital beds. Medicare Medicare is the federal government health insurance program that provides health care coverage if you are 65 or older, are under 65 and receive Social Security Disability Insurance (SSDI) for 24 months, begin receiving SSDI due to ALS/Lou Gehrig’s Disease, or have End-Stage Renal Disease (ESRD) no matter your age. You can receive health coverage directly through the federal government (see Original Medicare) or through a private company (see Medicare Advantage). ” data-gt-translate-attributes=””>Medicare only covers DME if your Provider See Health Care Provider. ” data-gt-translate-attributes=””>provider says it is Medically Necessary Medically necessary refers to procedures, services, or equipment that meet accepted medical standards and are necessary for the diagnosis and treatment of a medical condition. ” data-gt-translate-attributes=””>medically necessary for use in the home. « Back to Glossary Index

What is another word for DME?

Terminology – The term “Durable Medical Equipment” has multiple synonyms, such as Home Medical Equipment (HME), Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS), Assistive Technology (AT), or Assistive Devices (AD). DME refers to medical equipment and appliances designed for long-term, everyday usage, prescribed by a doctor or an occupational therapist for home use.

Blood sugar meters and test strips Canes, crutches, walkers, and other devices assisting users in walking long distances Commode chairs CPAP devices Hospital beds Infusion pumps and associated supplies Lancets and associated devices Mobile carts, including medication cabinet carts Nebulizers and associated medication Orthotic and prosthetic equipment Patient lifts Suction cups Traction equipment Wheelchairs, motorized wheelchairs, and indoor mobility scooters

It is crucial to differentiate DME from Home Medical Supplies (HMS), which refers to consumable or disposable medical equipment. Examples include adult diapers, bandages, speculums, dressing aids, catheters, needles, syringes, face masks, compression leggings, or surgical gloves.

What is the medical abbreviation for equipment?

D.M.E. is an abbreviation for Durable Medical Equipment.

What does Lymy stand for?

Whether you love to eat them, decorate with them, or use them to have some fun with your valentine, Brach’s Sweethearts conversation candies are one of the most iconic things about Valentine’s Day. But do you know their actual history? The brothers Oliver and Daniel Chase launched the New England Confectionary Company (NECCO) in 1860, and their first candy was the famous wafers.

After Daniel figured out a way to include a message with the candies, that became NECCO’s signature.
The brothers began taking orders in 1866 for weddings and other special occasions, and then took the idea to the public in 1902 with the launch of Sweethearts conversation hearts.
Eventually, Brach’s began making their own version of the candied hearts, and they now update their sayings constantly, explains Peter Goldman, senior director of Brach’s & Seasonal Confections of Ferrara Candy Company.

While some sayings turn up year after year, the company schedules numerous meetings to figure out what the hearts will say. “We start planning next year’s seasonal business one year out. As far as changing out specific sayings, we don’t necessarily add new sayings every year, but we do closely watch new phrases and quips that come into our everyday language,” he says.

Here are 15 more things you never knew about Valentine’s Day. Texting and social media have added to the options, Goldman says. As LOL and BFF have made their way into everyday language, they’ve also found their way onto the hearts. “Social media has added a treasure trove of new expressions, acronyms, and emoticons that have made their way onto Brach’s conversation hearts.

As we bring in new sayings, we retire some sayings that no longer seem as relevant to the current time,” he explains. However, it’s not just buzzwords that the company keeps up with: Color and flavor trends also have an impact on the brand. “We do continuous evaluation of all our products, including conversation hearts—tracking flavors, colors, and even textural trends—to make sure we are staying relevant and on top of emerging trends,” he says.

While some of the most popular sayings, like Be Mine, Love You, Let’s Kiss, Miss You, and Hug Me are timeless and always popular, says Goldman, every once in a while there is an error of sorts that makes the sayings a little bit different from originally planned. In an interview with The Atlantic, Hugh B.

Albert, production manager at NECCO, explained: “Our Ps sometimes look like Fs, so we can’t say anything like ‘Pucker Up’ for reasons you understand. Last year, we received a letter from a parent with a picture of a heart that was supposed to say ‘Smile.’ But because of the way the print came out—no S, a messy E—it ended up looking more like ‘MILF.’ Her son had no clue what that was about, so he asked his mom.

She wrote, ‘I don’t know what you people are doing.’ Anyway, we do our best to avoid things that have the Ps in them.
This is the human element.” So, what can we expect from the 2019 version of the iconic candy? Goldman said Brach’s will be rolling out some more modern sayings as well as text versions of sweet messages.

“Some of the newer sayings on Brach’s Conversation Hearts include TTYL (Talk To You Later), Adorbz, H&K (Hugs & Kisses), and LYMY (Love You Miss You).” Next, find out the most popular candy from the year you were born. Via Readers Digest.

What does HMW stand for in chat?

What does HMW stand for?

Rank Abbr.	Meaning
HMW	How might we
HMW	Haste Makes Waste
HMW	High Maintenance Woman

What does HHW stand for in text?

Sort results: alphabetical | rank ?


Rank Abbr.	Meaning
HHW	Hello, Happy World (BanG Dream! fandom)

showing only Slang/Internet Slang definitions ( show all 7 definitions ) Note: We have 15 other definitions for HHW in our Acronym Attic

What is another word for DME?

What is same or similar for DME?

Same or Similar: How to Avoid Denials Numerous DMEPOS claims deny because the equipment/item billed is the “same as” or “similar to” the equipment/item already in a beneficiary’s possession and is within its Reasonable Useful Lifetime (RUL). When such a claim denies, suppliers should submit a Redetermination request and include all applicable documentation, which may consist of details supporting lost or stolen items, or irreparable damage to item or medical records from the prescribing physician/practitioner to substantiate the need for a different item (change in medical condition), when appropriate.

Prior to providing an item, and to gain the necessary information required to determine whether an Advance Beneficiary Notice of Noncoverage (ABN) should be obtained or not, it is best to verify same or similar details within the in the Noridian Medicare Portal (NMP) or via the Interactive Voice Response (IVR).

The beneficiary or caregiver is another important source in determining whether same or similar items have previously been provided. Suppliers should ask the beneficiary or caregiver if they have received similar items in the past. It is important to note that the IVR and NMP will confirm that a beneficiary either has or not had a same or similar item with Jurisdiction A.

It is the supplier’s responsibility to check other jurisdictions for same or similar, including Jurisdiction D, if there is reason to believe that the beneficiary may have obtained a same or similar item within a different jurisdiction.
The claims in the NMP are specific to each Jurisdiction so each Jurisdiction, JA and JD, may need to be verified along with other jurisdiction’s portals for same or similar.

To access information about same or similar denials, ABN documentation, RUL clarification, billing reminders for RUL and duplicate Items, and a list of same or similar items, suppliers may also visit the webpage. Prior to replacing an item, and to gain the necessary information required for determining whether same or similar is affected, these questions should be considered:

Has there been a change in the beneficiary’s medical condition that supports the need for a same or similar type of item? Has the original item been lost, stolen, or irreparably damaged?

Answering these questions will help determine whether an Advance Beneficiary Notice of Noncoverage (ABN) should be obtained

Has the beneficiary had a same or similar item?

If he/she has not had a same or similar item, bill claim without obtaining an ABN (no ABN necessary) If he/she has had a same or similar item, determine if item has reached its RUL

If RUL reached, bill claim without ABN (no ABN necessary) If item has not reached RUL, obtain an and bill claim with applicable GA modifier

Last Updated Wed, 14 Sep 2022 18:44:25 +0000 : Same or Similar: How to Avoid Denials

Is a humidifier considered DME?

If you require a humidifier along with oxygen, it will be considered part of your Part B DME benefits. You can get your Medicare Part A and Part B benefits through Original Medicare or a Medicare Advantage (MA) plan.

What does HME stand for laryngectomy?

What is a heat moisture exchanger (HME)? A heat moisture exchanger (HME) has been designed to replicate the functions of the nose and upper airways to improve respiratory function following laryngectomy. After surgery, the air bypasses your nose and mouth and all breathing is done via the stoma opening in your neck.