Medical Supplies, Equipment and Appliances Durable Medical Equipment - MEDICAID - KENTUCKY

This Humana Medicaid (KY) DME/MSEA policy defines eligibility by DME-specific criteria (durability, home use, medical purpose, practitioner prescription, relation to functional needs) and lists device-specific coverage decisions. Multiple pediatric mobility and positioning devices, hospital bed types (with weight- and bed-confined criteria), seating/positioning systems, and repair/replacement rules are identified as potentially medically necessary when documentation supports the listed criteria; numerous devices (eg, safety sleep beds, oscillating/Stryker/springbase beds, certain monitors and activity systems) and home modifications are explicitly not medically necessary. Prior authorization is required for listed HCPCS codes and suppliers must provide device- and circumstance-specific documentation (including warranty, cost comparisons, diagnoses, functional limitations, weight, and proof of loss/damage) to support coverage.

"Prone Board (E1399): "May be considered medically necessary for a child with spastic quadriplegia""