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Locations

Northwest Ohio Medical Equipment, Bowling Green

Suite 5
1204 West Wooster Street
Bowling Green, OH 43402
Office Hours:

Monday - Friday
8:30 a.m. - 5 p.m.

Fax: 419.352.7252

Northwest Ohio Medical Equipment, Findlay

1749 Tiffin Avenue
Findlay, OH 45840
Office Hours:

Monday - Friday
8:30 a.m. - 5 p.m.

Fax: 419.420.8105

Northwest Ohio Medical Equipment, Fremont

1211 Oak Harbor Road
Fremont, OH 43420
Office Hours:

Monday - Friday
8:30 a.m. - 5 p.m.

Fax: 419.332.3384

Northwest Ohio Medical Equipment, Lima

Distribution Center
528 West Market Street
Lima, OH 45801

Northwest Ohio Medical Equipment, Maumee

Suite 7
5757 Monclova Road
Maumee, OH 43537
Office Hours:

Monday - Friday
8:30 a.m. - 5 p.m.

Fax: 419.891.4093

Northwest Ohio Medical Equipment, Upper Sandusky

100 South Sandusky Avenue
Upper Sandusky, OH 43351
Office Hours:

Monday - Friday
8:30 a.m. - 5 p.m.

Fax: 419.835.1176

Coverage Guidelines

Home Oxygen

Home Oxygen is covered only when patient test results meet all of the following conditions (1-3):

  1. Patient has a lung disease or hypoxia related condition and
  2. ABG or pulse oximetry is performed by a physician or qualified provider and
  3. ABG or pulse oximetry test meets one of more of the following criteria:
    1. Testing is completed within 48 hours of hospital discharge
    2. Testing is completed while in a chronic stable state and within 30 days of a discharge from a skilled nursing facility or provider visit
    3. ABG-55mmHg or below, or pulse oximetry is 88% or below at rest while awake on room air
    4. ABG-55mmHg or below, or pulse oximetry is 88% or below during sleep for five cumulative minutes
    5. ABG-55mmHg or below, or pulse oximetry is 88% or below during exercise

Test results must be recorded:

  • At rest on room air
  • During the exercise
  • While using oxygen during exercise

Patient must be seen and re-evaluated for home oxygen by the treating physician 9-12 months from the initial oxygen order.

Semi- electric Hospital Bed

Semi-electric hospital beds are only covered when the physician’s or nurse’s notes support the prescription and one of the four criteria below are met:

  1. Medical condition requires positioning not feasible with an ordinary bed (i.e. head elevation 30 degrees or more)
  2. Patient requires positioning of the body not feasible with an ordinary bed to alleviate pain
  3. Patient requires head of bed elevated more than 30 degrees due to CHF, COPD or aspiration risks
  4. Patient requires traction equipment, which can only be attached to a hospital bed

Nebulizer

Small volume nebulizers are covered only when the following medications are used for the specific diagnosis:

  1. Albuterol, Arformoterol, Budesonide, Cromolyn, Formoterol, Ipratropium, Levalbuterol, Metaproterenol for management of obstructive lung disease
  2. Dornase alpha for CF
  3. Tobramycin for CF or Bronchiectasis, Tuberculosis
  4. Pentamidine for HIV, Pneumocystosis or complications from organ transplants
  5. Acetylcysteine for persistent thick or tenacious pulmonary secretions

Standard Wheelchair

Standard wheelchairs are covered if A, B, C, D and E of the following are met and F or G is documented:

Physician/physical therapy notes document A - G below:

  1. Limitation that impairs ability to perform mobility-related activities of daily living (MRADL). A mobility limitation is one that:
    1. Prevents patients from accomplishing an MRADL entirely
    2. Places patient at heightened risk of morbidity or mortality while performing an MRADL, or
    3. Prevents patient from completing MRADL within a reasonable amount of time
  2. Patient is unable to use a cane or walker
  3. Patient’s home provides adequate access between rooms, maneuvering space and surface for wheelchair
  4. Wheelchair use will improve the ability to participate in MRADLs and patient will use it on a regular basis in home
  5. Patient is willing to use the manual wheelchair in the home
  6. The patient has sufficient upper extremity function and physical and mental capabilities needed to safely self-propel the manual wheelchair in the home
    - OR -
  7. The patient has a caregiver who is available, willing and able to provide assistance with the wheelchair

Walker

  1. Covered when physical therapy notes or physician notes contain mobility limitations impairing patient’s ability to participate in mobility-related activities of daily living (MRADL) in the home. Mobility limitation is one that:
    1. Prevents the patient from accomplishing the MRADL entirely
    2. Places the patient at reasonability heightened risk of morbidity or mortality secondary to not performing the MRADL, or
    3. Prevents the patient from completing the MRADL within a reasonable time frame
  2. Physical therapy or physician notes states patient cannot use a cane and can safely use a walker
  3. Physical therapy or physician notes the functional mobility deficit can be resolved with a walker

Enteral

Enteral nutrition is covered when one or more of the following patient conditions exist:

  1. Permanent non-functioning or disease of organ structures normally permitting food to reach the small bowel
  2. Disease of the small bowel impairing digestion and absorption of an oral diet, either of which requires tube feedings to provide sufficient nutrients to maintain weight and strength commensurate with the patient’s overall health status

Coverage may be possible for patients with partial impairments. For example, patients with dysphagia and experience limiting swallowing of food or Crohn’s disease who require prolonged infusion of enteral nutrients to overcome a problem with absorption.

Commode

Covered when documented in the notes that patient is physically incapable of utilizing regular toilet facilities:

  1. Patient is confined to a single room in the home without toilet facilities
  2. Patient is confined to a single floor in the home and no toilet facilities are on that floor, or
  3. Patient is confined to a home and no toilet facilities are in the home

 

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