E0300, Pediatric crib, hospital grade, fully enclosed, with or without top enclosure
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- Information supporting that the item can withstand repeated use (rental-use suitability) when applicable.
- Documentation that the item is not being furnished by a hospital or skilled nursing facility.
- Records or rationale supporting that the item is provided in the most cost-effective manner for the individual's condition (e.g., justification for purchase vs rental).
- No explicit documentation section provided in the excerpt.
Key Coverage Criteria
- Covered as DME when a safety enclosure with beds is required due to cognitive impairment or severe behavioral disorder, medications for seizures/behaviors are optimized or not appropriate, and a safety risk is present (e.g., claustrophobia, high fall risk, uncontrolled movements, violent or self-destructive behaviors).
- Is primarily and customarily used to serve a medical purpose rather than being primarily for comfort or convenience.
- Must be prescribed by a health care practitioner.
- Must be related to and meet the basic functional needs of the individual's physical disorder/condition.
- Not furnished by a hospital or skilled nursing facility (i.e., DME provided in those settings is excluded from this coverage).
- E0300 — Pediatric crib, hospital grade, fully enclosed, with or without top enclosure
10 Active Policies
HUMANA-MEDICAL-SUPPLIES-EQUIPMENT-AND-APPLIANCES-DURABLE-MEDICAL-EQUIPMENT-VA-MEDICAID, Medical Supplies, Equipment and Appliances Durable Medical Equipment
ANTHEM-CG-DME-15, CG-DME-15 Hospital Beds and Accessories
UHC-POL-beds-mattresses, Beds and Mattresses
DME101.001, Hospital Beds and Related Equipment
BCBSIL-DME101.001
Related Codes
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