Orthopedic Coding Alert

Question: Can we bill for supplying a patient with elastomer, coban? This is done on a 2nd office visit post op? If so what code can we use?

Answer: Medicare only covers infusion pumps that fall under the category of durable medical equipment (DME), which according to the Medicare Carriers Manual (Sect. 2100.1.A) means that "an item is considered durable if it can withstand repeated use, i.e., the type of item which could normally be rented." This means Medicare does not cover disposable pumps (like elastomeric pumps) and the drugs dispensed through them. Other payers however will pay for this as DME. You may bill as DME if you have a payer other than Medicare.