The Durable Medical Equipment (DME) Audit applies to both BCBSND Commercial and BCBSND Medicaid Expansion lines of business.
As part of the Provider Audit Work Plan, Blue Cross Blue Shield of North Dakota (BCBSND) is informing providers the Special Investigation Unit (SIU) and Provider Audit department is auditing Durable Medical Equipment (DME) supplies during the fourth quarter. This type of audit will typically impact both our Commercial and Medicaid Expansion lines of business. Refer to the medical policy section of our BCBSND website for more criteria information.
Durable Medical Equipment (DME) must meet the following conditions:
- Equipment must be able to withstand repeated use.
- It must be primarily and customarily used to serve a medical purpose.
- It must not be useful to a person in the absence of illness or injury.
- The equipment must be appropriate for use in the home.
All requirements of the definition must be met before an item can be considered DME.
For additional information or questions, email prov.partners@bcbsnd.com.
