DME billing means LCDs, capped rentals, modifiers for every rental month and prior auth on nearly everything. It’s the most rule-dense billing in healthcare - and we specialize in it.
The specialty-specific billing traps we fix every day for dme practices.
Every DME item lives under a Local Coverage Determination. We check coverage criteria before delivery so claims don’t die on medical necessity.
RR, KH, KI, KJ modifiers across 13 rental months - miss one and the claim denies. Our rental calendars track every month automatically.
Most DME needs auth before delivery. We run auth-first workflows so equipment ships only when coverage is confirmed.
Wrong HCPCS or missing PDAC verification means instant denial. We verify every code before the claim.
A sample of the dme codes where small errors cost real money.
| Code | What it covers | Where practices lose money |
|---|---|---|
| E0601 | CPAP device | Capped rental modifiers mismanaged across months 1–13. |
| L4360 | Walking boot | LCD criteria not documented at delivery - denied for medical necessity. |
| E0114 | Crutches | Bundled into surgical global or billed without separate justification. |
| K0001 | Standard wheelchair | Prior auth missing; competitive-bid area rules ignored. |
The same proven process behind every dme engagement.
Send one billing export. We map denials, AR aging and underpayments - free.
You get a prioritized action plan with projected recoveries before you commit.
Denials appealed, AR worked, workflows fixed - inside your systems.
Transparent reporting. You pay 5%% of what we collect - nothing else.
Straight answers for dme practices.
Send one billing export. We'll show you the leaks, the stuck AR and the denials worth fighting - before you spend a dollar.