HI 00601.410 Medical Supplies (Except for Drugs and Biologicals) and the Use of Medical Appliances
A. Medical supplies
Medical supplies are items which, due to their therapeutic or diagnostic characteristics, are essential in enabling HHA personnel to carry out effectively the care which the physician has ordered for the treatment or diagnosis of the patient's illness or injury. Certain items designed only to serve a medical purpose are considered to be medical supplies, e.g., catheters, needles, syringes, surgical dressings and material used for dressings such as cotton gauze and adhesive bandages, and materials used in aseptic techniques. Other medical supplies include, but are not limited to, irrigating solutions, intravenous fluids, and oxygen.
Other items, often used by persons who are not ill or injured, may be considered medical supplies but only when (1) the item is recognized as having the capacity to serve a therapeutic or diagnostic purpose in a specific situation, and (2) the item is required as part of the actual physician-prescribed treatment of a patient's existing illness or injury.
For example, items which generally serve a routine hygienic purpose, such as soaps and shampoos, and items which generally serve as skin conditioners, such as baby lotion, baby oil, skin softeners, powders, lotions, etc., are not considered medical supplies unless the particular item is recognized as serving a specific therapeutic purpose in the physician's prescribed treatment of the patient's existing skin (scalp) disease or injury.
B. Medical appliances
Medical appliances are items of medical equipment owned or rented by the HHA placed in the home of the patient to facilitate his treatment and rehabilitation. Medical appliances are generally defined as items which can withstand repeated use, are primarily and customarily used to serve a medical purpose, and are generally not useful to a person in the absence of illness or injury. This definition includes (but is not limited to), bedpans, hospital beds, wheelchairs, crutches, trapeze bars, oxygen tents, and intermittent positive pressure breathing machines.
Appliances which customarily serve a medical purpose but are also considerably useful to persons who are not ill or injured, appliances which customarily serve a nonmedical purpose but which may serve a medical purpose in a specific case, and appliances which are primarily designed to prevent illness or injury may be considered as medical appliances only when (1) the physician's plan of treatment specifically includes the use of such appliances in connection with the patient's treatment regimen and specifies any limitations which should be placed on the use of the appliance due to the patient's condition, and (2) the appliance may be expected to contribute meaningfully to the treatment of the illness or injury or to improve the functioning of a malformed body member. Examples of the type of appliances which may fall into this category include heat lamps, exercycles, flotation mattresses, bed baths, etc.
C. Drugs and biologicals
Drugs and biologicals are excluded from coverage as items or services administered by HHA's. They may, in certain cases, be covered under medical insurance, when administered by a physician as part of his professional service, and cannot be self-administered.