Clinicians Checklists - JD DME

• Automatic External Defibrillator - Wearable and Non-Wearable

• Continuous Glucose Monitors
• Glucose Monitors and Related Supplies
• Therapeutic Shoes for Persons with Diabetes

• Immunosuppressive Drugs
• Intravenous Immune Globulin
• Oral Anticancer Drugs

• Hospital Beds and Accessories

• Canes and Crutches
• Custom Manual Wheelchair
• Heavy Duty Wheelchairs
• Lightweight Wheelchairs
• Power Mobility Devices
• Power Operated Vehicle (POV)
• Push-Rim Activated Power Assist Device
• Standard Wheelchair
• Tilt-in-Space and Standard Hemi Wheelchairs
• Transport Chairs
• Walkers

• Negative Pressure Wound Therapy - Continuous Coverage
• Negative Pressure Wound Therapy - Home Setting
• Negative Pressure Wound Therapy - Inpatient Setting

• Enteral Nutrition
• Parenteral Nutrition

• Standard Written Orders

• Ankle-Foot/Knee-Ankle-Foot Orthosis
• Knee Orthoses - Custom and Prefabricated
• Spinal Orthoses
• Upper Limb Orthoses

Osteogenesis

• Osteogenesis Stimulators

• Ostomy Supplies

• Patient Lifts and Multi-Positional Patient Lifts

• Pneumatic Compression Devices - Chronic Venous Insufficiency with Venous Stasis Ulcers
• Pneumatic Compression Devices - Dates of Service On or After November 14, 2024
• Pneumatic Compression Devices E0650-E0651
• Pneumatic Compression Devices E0652 - Date of Service Prior to November 14, 2024

• External Breast Prostheses
• Lower Limb Prothesis - Initial
• Lower Limb Prosthesis - Replacement

• Refractive Lenses

• Central Sleep Apnea or Complex Sleep Apnea
• Continued RAD Therapy
• High Liter Flow Oxygen - Greater than 4 LPM
• Hypoventilation Syndrome - Respiratory Assist Devices (RADs) - With or Without Backup Feature
• Nebulizers
• Positive Airway Pressure (PAP)
• Respiratory Assist Device (RAD) - Restrictive Thoracic Disorder
• Respiratory Assist Device (RAD) - Severe COPD
• Ventilators

• Suction Pumps

• Pressure Reducing Support Surfaces - Group 1
• Pressure Reducing Support Surfaces - Group 2
• Pressure Reducing Support Surfaces - Group 3

• Surgical Dressings

• Transcutaneous Electrical Nerve Stimulators (TENS)
• Transcutaneous Electrical Nerve Stimulators (TENS) Conductive Garment

• Therapeutic Shoes for Persons with Diabetes

• Tracheostomy Care Supplies

• Urological Supplies