Coding for Standing Equipment

Altimate Medical's sit to stand standers are billed as DME (Durable Medical Equipment) to both Public and Private insurance companies and are routinely purchased. These products are designed to maintain function and design characteristics for repeated daily use by the patient for whom it is originally prescribed. These products are not useful in the absence of illness or injury.

In the past, alternative positioning and standing equipment was coded E1399 Miscellaneous. Since the administrative simplification provision of HIPAA (Health Insurance Portability and Accountability Act) of 1996 mandated Universal Coding, Altimate Medical applied to CMS for stander code verification and was placed in - E0637 (Combination sit to stand system, any size, with seat lift feature, with our without wheels) HCPCS code category.

Most payer sources are still implementing these Universal Coding changes. Please check with the payer source to verify what code they are currently using for our products. It should be E0637 or E1399.

As a supplier, you are aware of the importance of staying abreast of the latest changes in coding and coverage through your payer sources for all DME. Please let us know if you are having challenges or need assistance by calling Nancy Perlich at 877-844-1172. In many states there are supplier associations that may be helpful in dialoguing with other suppliers in your state and payer sources to correct the situation.

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“Standing the Test of Time: While reimbursement for pediatric standers varies from state to state, evidence continues to confirm the equipment's social and clinical benefits.”