The following items are considered convenience items, comfort items, hygienic equipment or not primarily medical in nature, and are non-covered.
|Adjustable high chair||T5001|
|Bathtub Lifts, Whirlpool tub, walk-in, portable||E0625, E1300, K1003|
|Bathtub/Shower chairs/seats||E0240, E0245, E0247, E0248|
|Bath tub Rail, Wall Rail||E0241, E0242, E0243, E0246|
|Control unit for electronic bowel irrigation/evacuation system||E0350|
|Disposable pack (water reservoir bag, speculum, valving mechanism and collection bag/box) for use with the electronic bowel irrigation/evacuation system||E0352|
|Ear Plugs (standard or custom-made)||E1399|
|Electric Adaptors (for car, truck, etc.)||E1399|
|Enema/Enema Bags/Enema tubes||A4458, K1013|
|Enuresis (Bed Wetting) Alarm||S8270|
|Exercise Equipment, Exercycle||A9300|
|Grab Bars||E0241, E0242, E0243, E0246|
|Heavy Cast Socks-6||E1399|
|Hot Water Bottle, ice cap or collar, heat and/or cold wrap, any type (includes ice pack)||A9273|
|Light Cast Sock-6||E1399|
|Lumex Ortho-Biotic High Back Rockers||E1399|
|Lumex Ortho-Biotic Recliners||E1399|
|Massage Chair/Robotic Chair||E1399|
|Mobile Monomatic Sanitation System||E1399|
|Niagara Massage Pillow||E1399|
|Positioning cushion/pillow/wedge, any shape or size||E0190|
|Positioning Support System||T5001|
|Posture support chair||T5001|
|Raised Toilet Seats||E0244|
|Reaching/Grabbing device, any type, any length, each||A9281|
|Safety car seats||E1399|
|Standard feeder seats||T5001|
|Standard high chairs||T5001|
|Tub rail attachment||E0246|
|Tub Stool or Bench||E0240, E0245, E0247, E0248|
|Versa Form chairs||T5001|
|Zero gravity chair||E1399|
The following items are considered environmental control equipment and are non-covered.
|Environmental control equipment||E1399|
|Heating and Cooling Plants||E1399|
|Portable Room Heaters||E1399|
The following items are considered educational equipment; and are not primarily medical in nature and are non-covered.
|Braille Teaching Texts||E1399|
The following items are considered inappropriate for home use or physician instruments or institutional equipment and are non-covered.
|American Bidet Toilet Seat||E1399|
|Aquamatic K-Thermia||E0217, E0236, E0249|
|Diathermy Machines, Low frequency ultrasonic diathermy treatment device for home use, includes all components and accessories||E0761, K1004|
|Hydrocollator Heating Unit||E0225, E0239|
|Intermittent Traction Unit||E1399|
|Paraffin Bath Units – non-portable||E1399|
The following items are considered non-reusable disposable supplies and are non-covered.
|Disposable Sheets and Bags||E1399|
|Incontinence Supplies and Incontinence garments and underpads||A4520, A4554, T4521, T4522, T4523, T4524, T4525, T4526, T4527, T4528, T4529, T4530, T4531, T4532, T4533, T4534, T4535, T4536, T4537, T4538, T4539, T4540, T4541, T4542, T4543, T4544|
Delivery, Setup and Service A9901 is non-covered as this is included in the service.
Telephone Alert Systems, E1399 are considered emergency communications systems and do not serve a diagnostic or therapeutic purpose and are therefore non-covered.